Healthcare Provider Details

I. General information

NPI: 1447698899
Provider Name (Legal Business Name): PTMS 3.0, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 02/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 N MAIN ST
NOBLE OK
73068-9322
US

IV. Provider business mailing address

307 N MAIN ST
NOBLE OK
73068-9322
US

V. Phone/Fax

Practice location:
  • Phone: 405-872-5900
  • Fax: 405-872-5901
Mailing address:
  • Phone: 405-872-5900
  • Fax: 405-872-5901

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 A FINLEY
Title or Position: MANAGER
Credential:
Phone: 405-809-8709