Oklahoma State SealOklahoma State Seal
Oklahoma Board of Medical Licensure and Supervision

Search Results

Last Update: Thursday, December 19, 2024 3:44 AM CST
Next Update: Thursday, December 19, 2024 12:00 PM CST

Return to Search Licensees page

BLACKBURN, AVERY LAUREN       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: SELECT PHYSICAL THERAPY
412 S BROADWAY AVE
SHAWNEE OK 74801

Address last updated on 10/3/2024
Phone #: (405) 273-1523
Fax #:
County: POTTAWATOMIE
License: 2034
Dated: 10/5/2018
Expires: 10/31/2025
Temp. Ltr. Issued: 8/27/2018
Temp. Ltr. Expires: 11/8/2018
License Type: Occupational Therapy Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
SELECT PHYSICAL THERAPY
412 S BROADWAY AVE
SHAWNEE OK 74801

Phone #: (405) 273-1523
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
CASSIDY RENEE MCCULLOUGH OT 2128

Return to Search Licensees page