Provider Demographics
NPI:1982387957
Name:EVANS, SUZANNE BETH
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:BETH
Last Name:EVANS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7738 N OWASSO EXPY
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-3338
Mailing Address - Country:US
Mailing Address - Phone:918-928-4255
Mailing Address - Fax:918-928-4258
Practice Address - Street 1:13330 S MEMORIAL DR STE 1&2
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-3119
Practice Address - Country:US
Practice Address - Phone:918-943-5084
Practice Address - Fax:855-940-1855
Is Sole Proprietor?:No
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant