Provider Demographics
NPI:1447061015
Name:HIGH, ALTON J (LMT)
Entity type:Individual
Prefix:
First Name:ALTON
Middle Name:J
Last Name:HIGH
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2724 BUSHEYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-9755
Mailing Address - Country:US
Mailing Address - Phone:405-436-3818
Mailing Address - Fax:
Practice Address - Street 1:2724 BUSHEYWOOD DR
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-9755
Practice Address - Country:US
Practice Address - Phone:405-436-3818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK203367225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist