Provider Demographics
NPI:1053319194
Name:CRANSTON, MARK S (PT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:S
Last Name:CRANSTON
Suffix:
Gender:M
Credentials:PT
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Mailing Address - Street 1:13512 N. EASTERN AVE, STE A
Mailing Address - Street 2:FUNCTIONAL PERFORMANCE TRAINING AND PHYSICAL THERAPY
Mailing Address - City:OKC
Mailing Address - State:OK
Mailing Address - Zip Code:73131-1812
Mailing Address - Country:US
Mailing Address - Phone:405-478-5333
Mailing Address - Fax:405-478-5334
Practice Address - Street 1:13512 N. EASTERN AVE, STE A
Practice Address - Street 2:FUNCTIONAL PERFORMANCE TRAINING AND PHYSICAL THERAPY
Practice Address - City:OKC
Practice Address - State:OK
Practice Address - Zip Code:73131-1812
Practice Address - Country:US
Practice Address - Phone:405-478-5333
Practice Address - Fax:405-478-5333
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2011-12-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKAT192251S0007X
OKPT10842251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports