Provider Demographics
NPI:1477932572
Name:HUNT, CHARLIE (ATC, LAT)
Entity Type:Individual
Prefix:MR
First Name:CHARLIE
Middle Name:
Last Name:HUNT
Suffix:
Gender:M
Credentials:ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 LAFAYETTE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-2011
Mailing Address - Country:US
Mailing Address - Phone:405-831-5986
Mailing Address - Fax:
Practice Address - Street 1:2321 LAFAYETTE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-2011
Practice Address - Country:US
Practice Address - Phone:405-831-5986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-21
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5922255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer