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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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BERRY, GLENN ARTHUR       
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: 1921 STONECIPHER BLVD
ADA OK 74820

Address last updated on 12/5/2024
Phone #: (580) 310-6635
Fax #: (580) 436-2675
County: PONTOTOC
License: 4288
Dated: 2/1/2010
Expires: 1/31/2026
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:
1921 STONECIPHER BLVD
ADA OK 74820

Phone #: (580) 310-6635
Fax #: (580) 436-2675
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
HEATHER LYNN ASKEW TA 726
WOODROW SCOTT CASTLEBERRY TA 2167
RACHAEL JONETTE DAVIS TA 901
RACHAEL JONETTE DAVIS TA 901
AMANDA NICOLE LANGWELL TA 1433
JACKIE WAYNE MCDANIEL TA 1265
JAMIE ERLINDA MOSE TA 1447
GERALD DAVID MUZAR TA 1810
HEATHER DAWN RHYNES TA 2721
GREGORY ROBERT STUBBS TA 2441

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