Provider Demographics
NPI:1447770763
Name:ZINK, KALIE (PT)
Entity Type:Individual
Prefix:
First Name:KALIE
Middle Name:
Last Name:ZINK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 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:405-809-8713
Mailing Address - Fax:
Practice Address - Street 1:3699 NW 32ND ST
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:OK
Practice Address - Zip Code:73065-6559
Practice Address - Country:US
Practice Address - Phone:405-387-5520
Practice Address - Fax:405-387-5404
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4827225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist