Provider Demographics
NPI:1336494095
Name:TEGTMEYER, JENNA (DPT, ATC)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:TEGTMEYER
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:SINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT, ATC
Mailing Address - Street 1:440 MERCHANT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6470
Mailing Address - Country:US
Mailing Address - Phone:405-809-8710
Mailing Address - Fax:
Practice Address - Street 1:440 MERCHANT DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6470
Practice Address - Country:US
Practice Address - Phone:405-809-8710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist