Provider Demographics
NPI:1346591732
Name:HOWARD, PHILIP ADRIAN (PT)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:ADRIAN
Last Name:HOWARD
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36684 EW 1270
Mailing Address - Street 2:
Mailing Address - City:WEWOKA
Mailing Address - State:OK
Mailing Address - Zip Code:74884-6532
Mailing Address - Country:US
Mailing Address - Phone:405-257-2254
Mailing Address - Fax:405-257-2254
Practice Address - Street 1:2506 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-3131
Practice Address - Country:US
Practice Address - Phone:405-214-0300
Practice Address - Fax:405-214-0301
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOK714225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist