| NPI | 1629452149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MARK TREADWELL CEO / Owner 580-490-3312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251S0007X Physical Therapist, Sports (Licence: OK 4555) |
| Enumeration Date | 2015-07-14 |
| Last Update Date | 2015-07-14 |