Healthcare Provider Details

I. General information

NPI: 1336750561
Provider Name (Legal Business Name): JOSEPH I ARVES SANTOS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2020
Last Update Date: 01/31/2024
Certification Date: 01/31/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 MINER RD
FORT SILL OK
73503-4437
US

IV. Provider business mailing address

2640 MINER RD
FORT SILL OK
73503-4437
US

V. Phone/Fax

Practice location:
  • Phone: 580-585-5600
  • Fax:
Mailing address:
  • Phone: 580-585-5600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number4075
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: