Individual
CARLIE MADISON APPLEGATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6715 E 41ST ST, TULSA, OK 74145-4520
(918) 806-0106
Mailing address
19611 S 397TH EAST AVE, PORTER, OK 74454-5919
(918) 616-1884
Taxonomy
Speciality
Code
Description
License number
State
2081P0010X
Pediatric Rehabilitation Medicine Physician
3113
OK
225200000X
Physical Therapy Assistant
Primary
3113
OK
Other
Enumeration date
01/20/2021
Last updated
01/20/2021
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