Provider Demographics
NPI:1407521784
Name:FRANSISCO, ALICIA ANN (PTA)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:ANN
Last Name:FRANSISCO
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23964 E 131ST ST S
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-8841
Mailing Address - Country:US
Mailing Address - Phone:918-933-3634
Mailing Address - Fax:
Practice Address - Street 1:3838 STATE ST STE 200
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-2528
Practice Address - Country:US
Practice Address - Phone:918-218-7280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-10
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3401225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy AssistantGroup - Single Specialty