Healthcare Provider Details

I. General information

NPI: 1316024441
Provider Name (Legal Business Name): PTMS 3.0, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14890 SE 29TH ST
CHOCTAW OK
73020-3515
US

IV. Provider business mailing address

14890 SE 29TH ST
CHOCTAW OK
73020-3515
US

V. Phone/Fax

Practice location:
  • Phone: 405-390-1731
  • Fax: 405-390-1981
Mailing address:
  • Phone: 405-390-1731
  • Fax: 405-390-1981

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateOK

VIII. Authorized Official

Name: BRIDGIT A FINLEY
Title or Position: MANAGER
Credential: PT
Phone: 405-809-8709