Basic Information
Provider Information
NPI: 1013295492
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOSHEE
FirstName: LAURA
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 440 MERCHANT DR
Address2:  
City: NORMAN
State: OK
PostalCode: 730696470
CountryCode: US
TelephoneNumber: 4058098713
FaxNumber:  
Practice Location
Address1: 15101 LLEYTONS CT STE 102
Address2:  
City: EDMOND
State: OK
PostalCode: 730132248
CountryCode: US
TelephoneNumber: 4057261580
FaxNumber: 4053106866
Other Information
ProviderEnumerationDate: 08/02/2011
LastUpdateDate: 09/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000X4485OKN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
174400000X4485OKY Other Service ProvidersSpecialist 

No ID Information.


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