Provider Demographics
NPI:1104147966
Name:COBLE, AMANDA BETH (MPT)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:BETH
Last Name:COBLE
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 WALL ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6342
Mailing Address - Country:US
Mailing Address - Phone:405-579-1600
Mailing Address - Fax:405-573-6768
Practice Address - Street 1:909 WALL ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6342
Practice Address - Country:US
Practice Address - Phone:405-579-1600
Practice Address - Fax:405-573-6768
Is Sole Proprietor?:No
Enumeration Date:2010-06-16
Last Update Date:2010-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic