Healthcare Provider Details

I. General information

NPI: 1073659033
Provider Name (Legal Business Name): OKLAHOMA PHYSICAL THERAPY SPINE CARE - REHAB, L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2007
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10325 GREENBRIAR PL
OKLAHOMA CITY OK
73159-7655
US

IV. Provider business mailing address

10325 GREENBRIAR PL STE B
OKLAHOMA CITY OK
73159-7647
US

V. Phone/Fax

Practice location:
  • Phone: 405-759-7719
  • Fax: 405-759-7718
Mailing address:
  • Phone: 405-759-7719
  • Fax: 405-759-7718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number710899208
License Number StateOK

VIII. Authorized Official

Name: DEREK EARL LEHMAN
Title or Position: OWNER
Credential:
Phone: 405-759-7719