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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, May 5, 2024 1:39 PM CDT
Next Update: Sunday, May 5, 2024 4:30 PM CDT

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TAKYI-MICAH, TIERRA LASHAWN FULTZ
Practice Address: 615 CLASSEN BLVD.
OKLAHOMA CITY OK 73106

Address last updated on 12/22/2023
Phone #: (405) 587-0415
Fax #:
County: OKLAHOMA
License: 5789
Dated: 8/5/2020
Expires: 1/31/2025
License Type: Physical Therapist
Specialty:
Status: Active
Status Class: Fully Licensed
Restricted to:
CME Year: 2026
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:
615 CLASSEN BLVD.
OKLAHOMA CITY OK 73106

Phone #: (405) 587-0415
Fax #:

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