Provider Demographics
NPI:1376761296
Name:LOVETT, RHONDA ANN (PT)
Entity Type:Individual
Prefix:
First Name:RHONDA
Middle Name:ANN
Last Name:LOVETT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:RHONDA
Other - Middle Name:ANN
Other - Last Name:MCCALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5542 E 112TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-7705
Mailing Address - Country:US
Mailing Address - Phone:918-518-5420
Mailing Address - Fax:
Practice Address - Street 1:5542 E 112TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-7705
Practice Address - Country:US
Practice Address - Phone:918-518-5420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2794225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist