Provider Demographics
NPI:1174596514
Name:BOBIER, BRIAN PEARCE (AT,C)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:PEARCE
Last Name:BOBIER
Suffix:
Gender:M
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 JOHNSON FARMS DR
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-9256
Mailing Address - Country:US
Mailing Address - Phone:405-441-4074
Mailing Address - Fax:
Practice Address - Street 1:3400 W TECUMSEH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-1810
Practice Address - Country:US
Practice Address - Phone:405-360-6764
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT2846174400000X
OK3862255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No174400000XOther Service ProvidersSpecialist