Healthcare Provider Details
I. General information
NPI: 1356459572
Provider Name (Legal Business Name): PTMS 3.0, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/28/2006
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3699 NW 32ND ST
NEWCASTLE OK
73065-6559
US
IV. Provider business mailing address
3699 NW 32ND ST
NEWCASTLE OK
73065-6559
US
V. Phone/Fax
- Phone: 405-387-5520
- Fax: 405-387-5404
- Phone: 405-387-5520
- Fax: 405-387-5404
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
BRIDGIT
A
FINLEY
Title or Position: MANAGER
Credential:
Phone: 405-809-8709