Provider Demographics
NPI:1720710189
Name:DARROW, JOANNA LYNN (PTA)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:LYNN
Last Name:DARROW
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W 166TH ST N
Mailing Address - Street 2:
Mailing Address - City:SKIATOOK
Mailing Address - State:OK
Mailing Address - Zip Code:74070-3670
Mailing Address - Country:US
Mailing Address - Phone:918-232-7638
Mailing Address - Fax:
Practice Address - Street 1:1815 E SKELLY DR
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-5919
Practice Address - Country:US
Practice Address - Phone:918-743-7838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-25
Last Update Date:2022-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1827225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant