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Oklahoma Board of Medical Licensure and Supervision

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

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SUSMILCH, MADISON LOUISE       
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: PHOENIX REHAB
1165 BRENNER RD
SAPULPA OK 74066

Address last updated on 1/28/2024
Phone #: (479) 524-3128
Fax #:
County: CREEK
License: 5559
Dated: 12/19/2022
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:
PHOENIX REHAB
1165 BRENNER RD
SAPULPA OK 74066

Phone #: (479) 524-3128
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
LINDA LEE CRANFIELD TA 2274
VICKI LYNN KOCHENOWER TA 692
MATHEW R LANE TA 2530
STEPHANY LEANN LITTLEJOHN TA 1266
ANDREW SCOTT LITTLEJOHN TA 1509
ALEXANDER PRICE TA 2973
CHASSITY AUTUMN RUBERT TA 921
MARY ALICE WHITE TA 113

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