Provider Demographics
NPI:1669659165
Name:ARMSTRONG, DAVID (RPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7380 S OLYMPIA AVE
Mailing Address - Street 2:PMB # 129
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74132-1849
Mailing Address - Country:US
Mailing Address - Phone:918-402-7688
Mailing Address - Fax:918-591-3899
Practice Address - Street 1:909 E 36TH ST N
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74106-1954
Practice Address - Country:US
Practice Address - Phone:918-402-7688
Practice Address - Fax:918-591-3899
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-28
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2334225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100834130AMedicaid
OKA101469OtherPTAN-INDIVIDUAL