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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Friday, April 19, 2024 4:47 PM CDT
Next Update: Saturday, April 20, 2024 2:50 AM CDT

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BLACKBURN, AVERY LAUREN
Practice Address: SELECT PHYSICAL THERAPY
412 S BROADWAY AVE
SHAWNEE OK 74801

Address last updated on 10/3/2023
Phone #: (405) 273-1523
Fax #:
County: POTTAWATOMIE
License: 2034
Dated: 10/5/2018
Expires: 10/31/2024
Temp. Ltr. Issued: 8/27/2018
Temp. Ltr. Expires: 11/8/2018
License Type: Occupational Therapy Assistant
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2024
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Locations: Hours: Languages:
SELECT PHYSICAL THERAPY
412 S BROADWAY AVE
SHAWNEE OK 74801

Phone #: (405) 273-1523
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
CASSIDY RENEE MCCULLOUGH OT 2128

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