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Individual

MRS. TIPHANIE S. MATHIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
801 NW 63RD ST, OKLAHOMA CITY, OK 73116-7603
(405) 879-9997
(405) 879-3397
Mailing address
801 NW 63RD ST, OKLAHOMA CITY, OK 73116-7603
(405) 879-9997
(405) 879-3397

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 2926
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200097800A
OK
Enumeration date
02/01/2006
Last updated
03/17/2010
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