Healthcare Provider Details

I. General information

NPI: 1912510843
Provider Name (Legal Business Name): PREMIER PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2020
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3100 W BRITTON RD STE H
OKLAHOMA CITY OK
73120-2036
US

IV. Provider business mailing address

3100 W BRITTON RD STE H
OKLAHOMA CITY OK
73120-2036
US

V. Phone/Fax

Practice location:
  • Phone: 405-849-9205
  • Fax: 405-400-8788
Mailing address:
  • Phone: 405-849-9205
  • Fax: 405-400-8788

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MATTHEW STEPHENS
Title or Position: MANAGING PARTNER
Credential:
Phone: 405-568-1318