Provider Demographics
NPI:1619238037
Name:FOX, JAMIE LEA (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:LEA
Last Name:FOX
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Gender:F
Credentials:PT, DPT
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Other - First Name:
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Mailing Address - Street 1:4812 S 109TH EAST AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74146-5822
Mailing Address - Country:US
Mailing Address - Phone:918-236-4590
Mailing Address - Fax:918-236-4595
Practice Address - Street 1:4812 S 109TH EAST AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74146-5822
Practice Address - Country:US
Practice Address - Phone:918-236-4590
Practice Address - Fax:918-236-4595
Is Sole Proprietor?:No
Enumeration Date:2012-06-01
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK46052251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic