Provider Demographics
NPI:1518502665
Name:HUFFERD, KAREN GAE (PTA)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:GAE
Last Name:HUFFERD
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:6802 S OLYMPIA AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-1826
Mailing Address - Country:US
Mailing Address - Phone:918-749-0762
Mailing Address - Fax:918-744-4246
Practice Address - Street 1:220 W 71ST ST # 2
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74132-2011
Practice Address - Country:US
Practice Address - Phone:918-749-0762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1841225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant