Provider Demographics
NPI:1235247768
Name:HAYES, MARGO (MS PT)
Entity Type:Individual
Prefix:
First Name:MARGO
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:RT 1 BOX 149
Mailing Address - Street 2:
Mailing Address - City:CUSTER CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73639
Mailing Address - Country:US
Mailing Address - Phone:580-593-2990
Mailing Address - Fax:580-583-2991
Practice Address - Street 1:RT 1 BOX 149
Practice Address - Street 2:
Practice Address - City:CUSTER CITY
Practice Address - State:OK
Practice Address - Zip Code:73639
Practice Address - Country:US
Practice Address - Phone:580-593-2990
Practice Address - Fax:580-583-2991
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK732225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist