Provider Demographics
NPI:1346450178
Name:SALVATORI, DARELYN LEE (RPTA)
Entity Type:Individual
Prefix:
First Name:DARELYN
Middle Name:LEE
Last Name:SALVATORI
Suffix:
Gender:F
Credentials:RPTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13306 E 84TH ST N
Mailing Address - Street 2:101
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-8691
Mailing Address - Country:US
Mailing Address - Phone:918-274-8066
Mailing Address - Fax:918-274-8066
Practice Address - Street 1:13306 E 84TH ST N
Practice Address - Street 2:101
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-8691
Practice Address - Country:US
Practice Address - Phone:918-274-8066
Practice Address - Fax:918-274-8066
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKTA146225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKTA146OtherSTATE LICENSE NUMBER