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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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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: 2401 W MAIN ST HENRYETTA OK 74437
HENRYETTA OK 74437

Address last updated on 11/10/2024
Phone #:
Fax #:
County: TULSA
License: 6336
Dated: 5/5/2023
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:
2401 W MAIN ST HENRYETTA OK 74437
HENRYETTA OK 74437

Phone #:
Fax #:
Primary Supervisees(s):
Name: Type: License Number: Full/Part Time:
NINA DEE MAAS TA 1416
CAROL RAY TAYLOR TA 2024

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