Provider Demographics
NPI:1154735199
Name:COGGINS, HEATHER RACHELLE (DPT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:RACHELLE
Last Name:COGGINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:RACHELLE
Other - Last Name:HOOCK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:825 E ROBINSON ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-6610
Mailing Address - Country:US
Mailing Address - Phone:405-364-7900
Mailing Address - Fax:405-310-6866
Practice Address - Street 1:825 E ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6610
Practice Address - Country:US
Practice Address - Phone:405-364-7900
Practice Address - Fax:405-310-6866
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4812225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist