Provider Demographics
NPI:1033507660
Name:HOWARD, KIMBERLY LOUISE (RPTA)
Entity Type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:LOUISE
Last Name:HOWARD
Suffix:
Gender:F
Credentials:RPTA
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:LOUISE
Other - Last Name:MORGAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPTA
Mailing Address - Street 1:PO BOX 4408
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74159
Mailing Address - Country:US
Mailing Address - Phone:918-272-1039
Mailing Address - Fax:918-272-7159
Practice Address - Street 1:12899 EAST 76TH ST NORTH
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055
Practice Address - Country:US
Practice Address - Phone:918-272-1039
Practice Address - Fax:918-272-7159
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-06
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1377225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant