Provider Demographics
NPI:1497873467
Name:NEWMAN, DANIEL J (MS, ATC, LAT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MS, ATC, LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8633 S 86TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4329
Mailing Address - Country:US
Mailing Address - Phone:918-250-2119
Mailing Address - Fax:
Practice Address - Street 1:6836 S MINGO RD
Practice Address - Street 2:UMAC - ATHLETIC DEPT
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-3310
Practice Address - Country:US
Practice Address - Phone:918-461-7893
Practice Address - Fax:918-461-7899
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAT207174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist