Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 2036 | OK |
Y | 2251X0800X | Physical Therapist - Orthopedic | 2036 | OK |
NPI | 1003876889 |
---|---|
Provider Name | Mrs. Sidonie R Bevier |
First Address | Oklahoma City, OK 73114-7408 |
Second Address | Norman, OK 73072-1803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 09/08/2019 |