Individual
MS. LORA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
825 NE 10TH ST, OUPB SUITE 5300, OKLAHOMA CITY, OK 73104-5417
(405) 271-9490
(405) 271-9491
Mailing address
825 NE 10TH ST, OUPB SUITE 5300, OKLAHOMA CITY, OK 73104-5417
(405) 271-9490
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3953
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1629185723
TRICARE
OK
05
—
200094760A
—
OK
Enumeration date
08/24/2006
Last updated
01/31/2013
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