PERRY, AUTUMN NICOLE - Licensee Information

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Last Update: Sunday, April 28, 2024 6:57 PM CDT
Next Update: Monday, April 29, 2024 2:50 AM CDT

PERRY, AUTUMN NICOLE

Practice Address:	THERAPITAS 14002 E 21ST ST SUITE 650 TULSA OK 74134 Address last updated on 1/11/2024
Phone #:	(918) 274-7902
Fax #:
County:	TULSA
License:	3411
Dated:	8/13/2021
Expires:	1/31/2025
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:
THERAPITAS 14002 E 21ST ST SUITE 650 TULSA OK 74134 Phone #: (918) 274-7902 Fax #:

Name:	Type:	License Number:
Primary Supervisor(s):
MARK EDWARD BROWN	PT	3421
JUSTIN-EDGAR VILLAFANIA MENDOZA	PT	6115

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Oklahoma State Board of Medical Licensure and Supervision :: 101 NE 51st St, Oklahoma City, OK 73105-1821
Main Number: (405) 962-1400 :: Fax: (405) 962-1440 :: Complaints outside 405 area code: 1-800-381-4519
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