Individual
MICHAEL DAVID BOONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
8201 NE 139TH ST, EDMOND, OK 73013-8705
(405) 396-2119
Mailing address
8201 NE 139TH ST, EDMOND, OK 73013-8705
(405) 396-2119
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT713
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT713
OK LICENSE BOARD
OK
Enumeration date
10/17/2007
Last updated
10/17/2007
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