Doctor Name: | MR. MARK S. CRANSTON |
NPI Number: | 1053319194 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | AT19 |
Business Practice Address: | 13512 N. Eastern Ave, Ste A Functional Performance Training And Physical Therapy Okc, OK - 731311812 |
Business Phone Number: | 4054785333 |
Business Fax Number: | 4054785333 |
Mailing Address: | 13512 N. Eastern Ave, Ste A, Functional Performance Training And Physical Therapy OKC |
State: | OK |
Postal Code: | 731311812 |
Phone Number: | 4054785333 |
Fax Number: | 4054785334 |
NPI Enumeration Date: | 07/12/2005 |
NPI Last Update Date: | 12/19/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251S0007X |
License Number: | AT19 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | OK |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Sports |
Taxonomy Definition: |