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Oklahoma Board of Medical Licensure and Supervision

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Last Update: Thursday, May 2, 2024 5:08 PM CDT
Next Update: Friday, May 3, 2024 2:50 AM CDT

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ELMORE, TRAVIS RYAN
Practice Address: FUNDAMENTALS THERAPY
1301 KIOWA ST
ARDMORE OK 73401

Address last updated on 1/29/2024
Phone #: (580) 850-1160
Fax #:
County: CARTER
License: 2450
Dated: 2/1/2015
Expires: 1/31/2025
Temp. Ltr. Issued: 10/10/2014
Temp. Ltr. Expires: 3/13/2015
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:
FUNDAMENTALS THERAPY
1301 KIOWA ST
ARDMORE OK 73401

Phone #: (580) 850-1160
Fax #:
Primary Supervisor(s):
Name: Type: License Number: Full/Part Time:
TANYA ELAINE SMITH PT 1928
CLAYTON COLE WARREN PT 3927

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