Provider Demographics
NPI:1073669727
Name:JEFFRIES, LYNN MARIE (PT, PHD, PCS)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:PT, PHD, PCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 NE 13TH ST
Mailing Address - Street 2:ROOM 251
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5005
Mailing Address - Country:US
Mailing Address - Phone:405-271-2131
Mailing Address - Fax:405-271-2432
Practice Address - Street 1:1600 N PHILLIPS AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-4619
Practice Address - Country:US
Practice Address - Phone:405-271-2131
Practice Address - Fax:405-271-2432
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT 1427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist