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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Sunday, April 28, 2024 1:44 PM CDT
Next Update: Sunday, April 28, 2024 4:30 PM CDT

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PERRY, SHASTA DAWN
Practice Address: SHANE PHYSICAL THERAPY
700 CR 33500
SUMNER TX 75486

Address last updated on 1/30/2024
Phone #: (903) 517-6360
Fax #: (903) 737-1951
County: NOT OKLAHOMA
License: 1371
Dated: 9/30/2004
Expires: 1/31/2025
Temp. Ltr. Issued: 8/13/2004
Temp. Ltr. Expires: 11/4/2004
License Type: Physical Therapist Assistant
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:
SHANE PHYSICAL THERAPY
700 CR 33500
SUMNER TX 75486

Phone #: (903) 517-6360
Fax #: (903) 737-1951
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
KENNETH SHANE HALCOMB PT 2635

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