Healthcare Provider Details

I. General information

NPI: 1144329202
Provider Name (Legal Business Name): ULTRA CARE THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2006
Last Update Date: 09/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2207 HASKELL BLVD
MUSKOGEE OK
74403-3513
US

IV. Provider business mailing address

2207 HASKELL BLVD
MUSKOGEE OK
74403-3513
US

V. Phone/Fax

Practice location:
  • Phone: 918-687-1451
  • Fax: 918-687-5220
Mailing address:
  • Phone: 918-687-1451
  • Fax: 918-687-5220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: EUNICE GUTHRIE
Title or Position: BUSINESS MANAGER
Credential:
Phone: 918-687-1451