IndividualActive
Jose Gamboa, PTA
NPI 1114549920 · Geriatric Physical Therapist · Oklahoma City, OK
Provider details
- NPI number
- 1114549920
- Entity type
- Individual
- Primary specialty
- Geriatric Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- License
- 2694 (OK)
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Practice location
9700 Mashburn Blvd
Oklahoma City, OK 73162-5509
Phone: (405) 721-2466
Approximate (ZIP-level) locationGet directions
Mailing address
9017 N University Ave Apt 14209
Oklahoma City, OK 73114-4312
Registry dates
- Enumerated
- 2020-05-14
- Last updated
- 2020-05-14
- Certified
- 2020-05-14
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.