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NPI Code Detail

MEDICARE: LARRY COMPTON

MEDICARE: LARRY COMPTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1547OTHEROKLICENSE #

General Provider Information

NPI Number : 1558478248
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARRY COMPTON
Provider Business Mailing Address
First Line : 1420 NORTHCREST DR
Second Line :
City : ADA
State : OK
Zip : 74820-4230
Country : US
Telephone Number : 405-436-2596
Fax Number :
Provider Business Practice Location Address
First Line : 2020 ARLINGTON ST
Second Line : STE 1
City : ADA
State : OK
Zip : 74820-2822
Country : US
Telephone Number : 580-332-5124
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2006
Last Update Date : 07/08/2007

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Directions to “ LARRY COMPTON ” Practice Location

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