Provider Demographics
NPI:1043508807
Name:FRANKS, ANITA (PTA)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:FRANKS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 N COUNTRY CLUB TER
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-6041
Mailing Address - Country:US
Mailing Address - Phone:405-659-4123
Mailing Address - Fax:
Practice Address - Street 1:713 N COUNTRY CLUB TER
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-6041
Practice Address - Country:US
Practice Address - Phone:405-659-4123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-14
Last Update Date:2011-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK833225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant