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Individual

DEBRA LORD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHYSICAL THERAPIST

Contact information

Practice address
12201 N WESTERN AVE, OKLAHOMA CITY, OK 73114-8022
(405) 752-5112
Mailing address
P.O. BOX 2496, EDMOND, OK 73083
(540) 845-8969

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305203022
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
192573
ANTHEM HEALTHKEEP PLUS
01
2111544
MDIPA
VA
05
4978145
VA
Enumeration date
10/03/2006
Last updated
11/17/2008
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