Healthcare Provider Details

I. General information

NPI: 1174927297
Provider Name (Legal Business Name): PTMS 3.0, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2014
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 W MAIN ST
HENRYETTA OK
74437-4242
US

IV. Provider business mailing address

402 W MAIN ST
HENRYETTA OK
74437-4242
US

V. Phone/Fax

Practice location:
  • Phone: 918-652-0443
  • Fax: 918-652-0434
Mailing address:
  • Phone: 918-652-0443
  • Fax: 918-652-0434

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: BRIDGIT FINLEY
Title or Position: MANAGER
Credential:
Phone: 405-809-8710