Healthcare Provider Details

I. General information

NPI: 1568488179
Provider Name (Legal Business Name): PHYSICAL THERAPY CLINIC OF PARIS LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2006
Last Update Date: 11/26/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E JACKSON ST
HUGO OK
74743-4238
US

IV. Provider business mailing address

2875 LEWIS LN SUITE B
PARIS TX
75460-9331
US

V. Phone/Fax

Practice location:
  • Phone: 580-326-0036
  • Fax:
Mailing address:
  • Phone: 903-785-3861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251S0007X
TaxonomySports Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DOUGLAS E WEHRMAN
Title or Position: ADMINISTRATOR
Credential: PT
Phone: 903-785-3861