Provider Demographics
NPI:1497772057
Name:PLATT, DARRELL L (PT)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:L
Last Name:PLATT
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2232 W HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-3529
Mailing Address - Country:US
Mailing Address - Phone:918-259-9522
Mailing Address - Fax:918-259-9521
Practice Address - Street 1:2424 E 21ST ST
Practice Address - Street 2:STE 400
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-1711
Practice Address - Country:US
Practice Address - Phone:918-743-9235
Practice Address - Fax:918-743-9234
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2230225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist