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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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ANTHONY, LETITIA BUGJO       
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: 360 PHYSICAL THERAPY/HUMAN PERFORMANCE CENTERS
13801 NORTH WESTERN AVENUE
SUITE B
EDMOND OK 73013
Address last updated on 1/18/2024
Phone #: (405) 946-7300
Fax #:
County: OKLAHOMA
License: 2961
Dated: 11/4/1999
Expires: 1/31/2025
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:
360 PHYSICAL THERAPY/HUMAN PERFORMANCE CENTERS
13801 NORTH WESTERN AVENUE
SUITE B
EDMOND OK 73013
Phone #: (405) 946-7300
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
ELIZABETH GUTIERREZ TA 3137
DANIELLE FRANCES JOHNSON TA 3506
ALEX KURIAN TA 3145
MEAGAN DAYNE MARQUEZ TA 2468
FRANK STEVEN POLLACK IV TA 3551
KIMBERLY DAWN ROBERTS TA 3305
DAKOTA KELSO SHEPHERD TA 2803
JADE ONEAL STAGGS TA 3319
HOLLY ELIZABETH TATE TA 2022

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