Provider Demographics
NPI:1174199194
Name:YORK, KAMBREE J (DPT)
Entity Type:Individual
Prefix:
First Name:KAMBREE
Middle Name:J
Last Name:YORK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 GRANT BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-0038
Mailing Address - Country:US
Mailing Address - Phone:405-730-0606
Mailing Address - Fax:
Practice Address - Street 1:4400 GRANT BLVD STE 105
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-0038
Practice Address - Country:US
Practice Address - Phone:405-730-0606
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-01
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5994225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist