WAGNER, LESLIE LIGHTFOOT - 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

WAGNER, LESLIE LIGHTFOOT

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:	COMMUNITY HOSPITAL OUTPATIENT THERAPY 10001 SOUTH WESTERN #102 OKLAHOMA CITY OK 73139 Address last updated on 1/8/2024
Phone #:	(405) 691-5434
Fax #:
County:	OKLAHOMA
License:	841
Dated:	12/2/1999
Expires:	1/31/2025
Temp. Ltr. Issued:	5/27/1999
Temp. Ltr. Expires:	1/31/2000
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:
COMMUNITY HOSPITAL OUTPATIENT THERAPY 10001 SOUTH WESTERN #102 OKLAHOMA CITY OK 73139 Phone #: (405) 691-5434 Fax #:

Name:	Type:	License Number:	Full/Part Time:
Primary Supervisor(s):
MICHAEL BRAD FINLEY	PT	1517

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