Provider Demographics
NPI:1861667396
Name:MARILYN L ALLEN
Entity Type:Organization
Organization Name:MARILYN L ALLEN
Other - Org Name:HAND REHABILITATION OF TULSA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:DEENA
Authorized Official - Middle Name:D
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-748-7500
Mailing Address - Street 1:1919 S WHEELING AVE
Mailing Address - Street 2:SUITE 604
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5638
Mailing Address - Country:US
Mailing Address - Phone:918-748-4500
Mailing Address - Fax:918-748-7615
Practice Address - Street 1:1919 S WHEELING AVE
Practice Address - Street 2:SUITE 604
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5638
Practice Address - Country:US
Practice Address - Phone:918-748-4500
Practice Address - Fax:918-748-7615
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK10902251H1200X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251H1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistHandGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100836340AMedicaid
OK542481682Medicare PIN
OK0216210001Medicare NSC