Provider Demographics
NPI:1487942769
Name:CLAWSON, STEPHANIE ANN (MPT)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANN
Last Name:CLAWSON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 NW 7TH ST
Mailing Address - Street 2:SUITE 302
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73102-1212
Mailing Address - Country:US
Mailing Address - Phone:405-609-3675
Mailing Address - Fax:800-506-3795
Practice Address - Street 1:1091 S CORNWELL DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-4554
Practice Address - Country:US
Practice Address - Phone:405-354-6698
Practice Address - Fax:405-354-6609
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4329225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist