Basic Information
| Provider Information | |||||||||
| NPI: | 1548695042 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | POSTON-SHANNON | ||||||||
| FirstName: | WHITNEY | ||||||||
| MiddleName: | SHEA | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 SE 3RD ST | ||||||||
| Address2: | |||||||||
| City: | PERKINS | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740593407 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4058800169 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1401 W PAWNEE ST | ||||||||
| Address2: | |||||||||
| City: | CLEVELAND | ||||||||
| State: | OK | ||||||||
| PostalCode: | 740203033 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9183582501 | ||||||||
| FaxNumber: | 9183583307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2013 | ||||||||
| LastUpdateDate: | 09/04/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 3128 | OK | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.