Provider Demographics
NPI:1174035653
Name:ALLEN-HUFFLING, KATHY SUE (PT)
Entity Type:Individual
Prefix:
First Name:KATHY
Middle Name:SUE
Last Name:ALLEN-HUFFLING
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KATHY
Other - Middle Name:SUE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1601 STRAYFOX XING
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-2082
Mailing Address - Country:US
Mailing Address - Phone:405-412-3144
Mailing Address - Fax:
Practice Address - Street 1:2200 NW 50TH ST STE 109E
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-8044
Practice Address - Country:US
Practice Address - Phone:405-412-3144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2017-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2248225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist