| NPI | 1407368160 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANE LEE CASEY Physical Therapist 405-808-8128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: OK 4745) |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic (Licence: OK 4745) |
| 261QA0900X Clinic/Center, Amputee (Licence: OK 4745) | |
| Enumeration Date | 2017-11-02 |
| Last Update Date | 2018-02-22 |