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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Saturday, December 21, 2024 3:49 AM CST
Next Update: Saturday, December 21, 2024 12:00 PM CST

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STOVALL, SHANE DARRELL       
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: PROHAB THERPY SPECIALISTS
1107 W BROADWAY
ARDMORE OK 73401

Address last updated on 12/30/2023
Phone #: (580) 226-5566
Fax #: (580) 223-6448
County: CARTER
License: 2905
Dated: 7/22/1999
Expires: 1/31/2025
Temp. Ltr. Issued: 7/1/1999
Temp. Ltr. Expires: 9/18/1999
License Type: Physical Therapist
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:
PROHAB THERPY SPECIALISTS
1107 W BROADWAY
ARDMORE OK 73401

Phone #: (580) 226-5566
Fax #: (580) 223-6448
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
JOSHUA ANTHONY BUTTON TA 2126
JOHANNA ALENE CUMMINGS TA 1077
JACOB DANIEL DUPREE TA 2840
AMANDA LEA FAUGHT TA 1082
RYAN MILLER GIBSON TA 2712
KELSIE RENEE GOETZ TA 2130
HUMBERTO GRIMALDO-SALAZAR TA 1948
DEBORAH DIANE HILDEBRAND TA 818
TENLEY ELIZABETH HILL TA 1099
JESSICA EMILYE JACKSON TA 2475
ALEXIS DAWN JACKSON TA 2766
ALICIA DAWN JOBE TA 3398
LAUREN NOELLE JONES TA 2708
VICTORIA JUNE JONES TA 1630
AMANDA BROOKE KENNEDY TA 1749
DOROTHEA INGE KERNS TA 1628
LA TOYA MECHELLE MEYER TA 1836
KEISHA JUANELL NELSON TA 1750
MELISSA DAWN PARKER TA 3193
HAYDEN M'LISS PERRY TA 3333
MORGAN DEANN PHILLIPS TA 2857
GLENNA ARLENE PIPINS TA 76
KAITLYN BETH RICHARDSON TA 3744
CHASSITY AUTUMN RUBERT TA 921
LEAH MARIE RYAN TA 1477
BRECKEN LEE WAITMAN TA 3148
ALLI MARIE WILLIS TA 3862
DAMION WOLFE TA 2523

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