Individual
MRS. JOANNE R WALKUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1024 NW 47TH ST, OKLAHOMA CITY, OK 73118-6400
(405) 650-9405
(405) 606-2008
Mailing address
6804 OLD ORCHARD LN, OKLAHOMA CITY, OK 73132-3902
(405) 722-9736
(405) 722-9736
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
1204
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100645000A
—
OK
01
—
100645000D
MEDICAID DME
OK
01
—
1972645836
HEALTH CHOICE
OK
Enumeration date
02/13/2007
Last updated
05/15/2020
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