Provider Demographics
NPI:1659391654
Name:SIMPSON, LAURA LYNN (PT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNN
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:OLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1525 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CUSHING
Mailing Address - State:OK
Mailing Address - Zip Code:74023-3039
Mailing Address - Country:US
Mailing Address - Phone:918-225-2225
Mailing Address - Fax:918-225-4915
Practice Address - Street 1:1525 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CUSHING
Practice Address - State:OK
Practice Address - Zip Code:74023-3039
Practice Address - Country:US
Practice Address - Phone:918-225-2225
Practice Address - Fax:918-225-4915
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2020-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2063225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist