Provider Demographics
NPI:1578773198
Name:CROOKS, TONY ALAN (MPT)
Entity Type:Individual
Prefix:MR
First Name:TONY
Middle Name:ALAN
Last Name:CROOKS
Suffix:
Gender:M
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9816 MAHLER PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-3310
Mailing Address - Country:US
Mailing Address - Phone:405-361-3225
Mailing Address - Fax:
Practice Address - Street 1:5300 N INDEPENDENCE AVE STE 100
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73112-5550
Practice Address - Country:US
Practice Address - Phone:405-945-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist