Provider Demographics
NPI:1023017449
Name:TARKINGTON, MARQUITA RAENELLE (LPT)
Entity type:Individual
Prefix:
First Name:MARQUITA
Middle Name:RAENELLE
Last Name:TARKINGTON
Suffix:
Gender:F
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9136 S SHERIDAN RD STE B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-5328
Mailing Address - Country:US
Mailing Address - Phone:918-488-9991
Mailing Address - Fax:918-488-9989
Practice Address - Street 1:9136 S SHERIDAN RD STE B
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5328
Practice Address - Country:US
Practice Address - Phone:918-488-9991
Practice Address - Fax:918-488-9989
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist