GRIDER, PHILIP WAYNE - Licensee Information

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Last Update: Wednesday, December 18, 2024 6:43 PM CST
Next Update: Thursday, December 19, 2024 2:50 AM CST

GRIDER, PHILIP WAYNE

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:	PHYSICAL THERAPY CENTRAL EAST MOORE 2100 N EASTERN AVE STE 4 MOORE OK 73160 Address last updated on 1/16/2024
Phone #:	(405) 676-6030
Fax #:	(405) 676-6031
County:	CLEVELAND
License:	4983
Dated:	5/29/2015
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:
PHYSICAL THERAPY CENTRAL EAST MOORE 2100 N EASTERN AVE STE 4 MOORE OK 73160 Phone #: (405) 676-6030 Fax #: (405) 676-6031

Name:	Type:	License Number:
Primary Supervisees(s):
BRANTLEY THOMAS LAWSON	TA	3616
DAWN NICOLE RIPLEY	TA	1893

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