Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jacob Lively

Individual provider Physical Therapy Assistant · NPI 1407447998

Jacob Lively is a Physical Therapy Assistant in Moore, Oklahoma. Registered with an NPI since 2021.

In the registry since
2021

Practice location Address checks out

526 SW 4th St Ste 200
Moore, OK 73160-5409
Phone: (405) 759-2700
Fax: (405) 759-2722
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X

Record details

NPI number1407447998
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJanuary 28, 2021
Last updated in NPPESJanuary 28, 2021
Certification dateJanuary 28, 2021
Mailing address526 Sw 4th St Ste 200, Moore, OK 73160-5409

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