Individual
DR. KYLE WOMACK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
1501 N BROADWAY AVE, OKLAHOMA CITY, OK 73103-4609
(405) 633-0193
Mailing address
1213 SW 18TH ST, OKLAHOMA CITY, OK 73108-7217
(405) 641-6263
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT4020
HI
2251S0007X
Sports Physical Therapist
Primary
4951
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
N/A
—
Enumeration date
06/22/2015
Last updated
04/30/2024
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