Healthcare Provider Details

I. General information

NPI: 1710916937
Provider Name (Legal Business Name): PHYSIOTHERAPY ASSOCIATES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 09/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3549 W MEMORIAL RD
OKLAHOMA CITY OK
73134-7015
US

IV. Provider business mailing address

3820 AMERICAN DR SUITE 340
PLANO TX
75075-6101
US

V. Phone/Fax

Practice location:
  • Phone: 405-749-7950
  • Fax: 405-749-7940
Mailing address:
  • Phone: 469-467-8705
  • Fax: 267-321-2550

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CYNTHIA L. GOLDBERG
Title or Position: CHIEF COMPLIANCE OFFICER
Credential:
Phone: 610-644-7824