MCCRACKEN, CHEYENNE AUTUMN - 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

MCCRACKEN, CHEYENNE AUTUMN

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:	REHAB SOURCE 4350 WILL ROGERS PARKWAY SUIET 600 OKLAHOMA CITY OK 73108 Address last updated on 12/28/2023
Phone #:	(918) 290-1273 x2813
Fax #:
County:	OKLAHOMA
License:	3081
Dated:	8/13/2019
Expires:	1/31/2025
License Type:	Physical Therapist Assistant
Specialty:

Status:	Active
Status Class:	Fully Licensed
Restricted to:
CME Year:	2025

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:
REHAB SOURCE 4350 WILL ROGERS PARKWAY SUIET 600 OKLAHOMA CITY OK 73108 Phone #: (918) 290-1273 x2813 Fax #:

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