Healthcare Provider Details

I. General information

NPI: 1578675070
Provider Name (Legal Business Name): PRECISION PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20208 NE 23RD ST
HARRAH OK
73045-9123
US

IV. Provider business mailing address

PO BOX 746
HARRAH OK
73045-0746
US

V. Phone/Fax

Practice location:
  • Phone: 405-454-0010
  • Fax: 405-454-0030
Mailing address:
  • Phone: 405-454-0010
  • Fax: 405-454-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: PAULINE GILLESPIE
Title or Position: DIRECTOR OF BILLING
Credential:
Phone: 405-347-5123