WHITBECK, BLAKELEY MATTHEW - 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

WHITBECK, BLAKELEY MATTHEW

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:	BLAKE WHITBECK PTA LLC. 807 E. JEFFERSON ST. HUGO OK 74743 Address last updated on 2/12/2024
Phone #:	(580) 317-7455
Fax #:	(580) 743-8047
County:	CHOCTAW
License:	2709
Dated:	10/18/2016
Expires:	1/31/2025
License Type:	Physical Therapist Assistant
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:
BLAKE WHITBECK PTA LLC. 807 E. JEFFERSON ST. HUGO OK 74743 Phone #: (580) 317-7455 Fax #: (580) 743-8047

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
KENNETH SHANE HALCOMB	PT	2635

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