Provider Demographics
NPI:1023266772
Name:PARKER, ABIGAIL LEIGH (PT)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:LEIGH
Last Name:PARKER
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 1:1125 S TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74120-5418
Mailing Address - Country:US
Mailing Address - Phone:918-579-7124
Mailing Address - Fax:
Practice Address - Street 1:1125 S TRENTON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-5418
Practice Address - Country:US
Practice Address - Phone:918-579-7124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-07
Last Update Date:2008-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3979225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist