Provider Demographics
NPI:1003121773
Name:WHITT, JOE KENT (RPT)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:KENT
Last Name:WHITT
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2105 N BEARD ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3501
Mailing Address - Country:US
Mailing Address - Phone:405-990-5961
Mailing Address - Fax:405-214-6299
Practice Address - Street 1:2105 N BEARD ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-3501
Practice Address - Country:US
Practice Address - Phone:405-990-5961
Practice Address - Fax:405-214-6299
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-18
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT1479225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist