Provider Demographics
NPI:1023017449
Name:TARKINGTON, MARQUITA RAENELLE (LPT)
Entity Type:Individual
Prefix:
First Name:MARQUITA
Middle Name:RAENELLE
Last Name:TARKINGTON
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9050 E 30TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74129-6835
Mailing Address - Country:US
Mailing Address - Phone:918-665-7027
Mailing Address - Fax:918-836-9106
Practice Address - Street 1:8523 E 11TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112-7963
Practice Address - Country:US
Practice Address - Phone:918-836-9100
Practice Address - Fax:918-836-9106
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist