Provider Demographics
NPI:1477768893
Name:KILLMAN, LATRICIA A (PT)
Entity Type:Individual
Prefix:MS
First Name:LATRICIA
Middle Name:A
Last Name:KILLMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:LATRICIA
Other - Middle Name:A
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1541 N SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74115-4610
Mailing Address - Country:US
Mailing Address - Phone:918-836-5406
Mailing Address - Fax:918-832-8618
Practice Address - Street 1:1541 N SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74115-4610
Practice Address - Country:US
Practice Address - Phone:918-836-5406
Practice Address - Fax:918-832-8618
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist