Provider Demographics
NPI:1689284291
Name:FLANARY, LAUREN ASHELLY (DPT)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHELLY
Last Name:FLANARY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4157 S HARVARD AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2606
Mailing Address - Country:US
Mailing Address - Phone:918-949-4390
Mailing Address - Fax:918-392-7878
Practice Address - Street 1:4157 S HARVARD AVE STE 101
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2606
Practice Address - Country:US
Practice Address - Phone:918-949-4390
Practice Address - Fax:918-392-7878
Is Sole Proprietor?:No
Enumeration Date:2020-08-07
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT5909225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist