Provider Demographics
NPI:1891848826
Name:ANDREW, KAROL A (PT)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:A
Last Name:ANDREW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2662 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3123
Mailing Address - Country:US
Mailing Address - Phone:918-691-7698
Mailing Address - Fax:918-742-7698
Practice Address - Street 1:2662 E 22ND ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3123
Practice Address - Country:US
Practice Address - Phone:918-691-7698
Practice Address - Fax:918-742-7698
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK765225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist