| Mrs Ashley Diane Fanning, PT | |
|
1125 40th St Ste D, Woodward, OK 73801-1700 | |
| (405) 201-0204 | |
| Not Available |
| Full Name | Mrs Ashley Diane Fanning |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 1125 40th St Ste D, Woodward, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952745002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 4211 (Oklahoma) | Primary |
| Provider Name | Northwest Physical Therapy And Sports Rehab, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1497067771 PECOS PAC ID: 7113102294 Enrollment ID: O20110505000315 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Ashley Diane Fanning, PT 2800 Oak Hollow Rd, Woodward, OK 73801-7126 Ph: (405) 201-0204 | Mrs Ashley Diane Fanning, PT 1125 40th St Ste D, Woodward, OK 73801-1700 Ph: (405) 201-0204 |
Jai A Barby, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1125 40th St, Suite D, Woodward, OK 73801 Phone: 580-256-2102 Fax: 580-256-1410 | |
Dr. Michelle Anne Johnson, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1011 Texas St, Woodward, OK 73801 Phone: 580-205-2035 Fax: 580-205-2038 | |
Choice Physical Therapy Physical Therapist Medicare: Medicare Enrolled Practice Location: 4900 Oklahoma Ave Ste 200, Woodward, OK 73801 Phone: 405-229-7840 | |
Mr. Donald Joseph Lauderdale I, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1723 Kansas Ave, Woodward, OK 73801 Phone: 580-256-4050 Fax: 580-256-4072 | |
Jordan Ross, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2630 Oklahoma Ave, Woodward, OK 73801 Phone: 580-256-2102 Fax: 580-256-1410 | |
Shannon Rose, PT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 2630 Oklahoma Ave, Woodward, OK 73801 Phone: 580-256-2102 Fax: 580-256-1410 | |
Mr. Matthew J Harrington, PT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1125 40th St, Suite D, Woodward, OK 73801 Phone: 580-256-2102 Fax: 580-256-1410 |