Provider Demographics
NPI:1174743330
Name:HENDERSON, ZELA J (PT)
Entity type:Individual
Prefix:
First Name:ZELA
Middle Name:J
Last Name:HENDERSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:504 EAST YUMA DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74011-7215
Mailing Address - Country:US
Mailing Address - Phone:918-455-3905
Mailing Address - Fax:918-451-5287
Practice Address - Street 1:3000 S ELM PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7917
Practice Address - Country:US
Practice Address - Phone:918-451-5225
Practice Address - Fax:918-451-5287
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKPT958225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist