Organization
STATE OF OKLAHOMA
Active
Other names
d/b/a OSU-Omulgee Orthotic, Prosthetic and Pedorthic Center
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHELLEY PERKINS CO,PLO,BOCOC,C.PED. (CLINICAL DIRECTOR)
(918) 293-5155
Entity
Organization
Contact information
Practice address
1801 E 4TH ST, OKMULGEE, OK 74447-3942
(918) 293-5155
(918) 293-5407
Mailing address
PO BOX 2506, OKMULGEE, OK 74447-8501
(918) 293-5155
(918) 293-5407
Taxonomy
Speciality
Code
Description
License number
State
332BC3200X
Customized Equipment (DME)
3
OK
335E00000X
Prosthetic/Orthotic Supplier
Primary
13
OK
335E00000X
Prosthetic/Orthotic Supplier
3
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NO NUMBER
LIMBS FOR LIFE
OK
01
—
NO NUMBER TO DATE
COMMUNITY CARE HEALTH
OK
Enumeration date
03/29/2006
Last updated
09/11/2025
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