Provider Demographics
NPI:1972645836
Name:WALKUP, JOANNE R (PT)
Entity type:Individual
Prefix:MRS
First Name:JOANNE
Middle Name:R
Last Name:WALKUP
Suffix:
Gender:F
Credentials:PT
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Mailing Address - Street 1:6804 OLD ORCHARD LN
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3902
Mailing Address - Country:US
Mailing Address - Phone:405-722-9736
Mailing Address - Fax:405-722-9736
Practice Address - Street 1:1024 NW 47TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-6400
Practice Address - Country:US
Practice Address - Phone:405-650-9405
Practice Address - Fax:405-606-2008
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12042251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100645000DOtherMEDICAID DME
OK100645000AMedicaid
OK1972645836OtherHEALTH CHOICE
OK1972645836OtherBLUE CROSS BLUE SHIELD