Healthcare Provider Details

I. General information

NPI: 1881648483
Provider Name (Legal Business Name): REHAB AMERICA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 04/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1044 SW 44TH ST SUITE 415 # JOHNNIE
OKLAHOMA CITY OK
73109-3609
US

IV. Provider business mailing address

1044 SW 44TH ST SUITE 415 # JOHNNIE
OKLAHOMA CITY OK
73109-3609
US

V. Phone/Fax

Practice location:
  • Phone: 405-631-4263
  • Fax: 405-631-4820
Mailing address:
  • Phone: 405-631-4263
  • Fax: 405-631-4820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License NumberN/A
License Number StateOK

VIII. Authorized Official

Name: DR. JOEL L FRAZIER
Title or Position: PRESIDENT
Credential: MD
Phone: 405-609-6145