Healthcare Provider Details

I. General information

NPI: 1487833885
Provider Name (Legal Business Name): VALIR OUTPATIENT CLINIC #9 LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2007
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3306 N KICKAPOO AVE STE 200
SHAWNEE OK
74804-1717
US

IV. Provider business mailing address

700 NW 7TH ST
OKLAHOMA CITY OK
73102-1212
US

V. Phone/Fax

Practice location:
  • Phone: 405-214-9808
  • Fax:
Mailing address:
  • Phone: 405-609-3658
  • Fax: 800-506-3795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: NIKKI HARRIS
Title or Position: DIRECTOR
Credential:
Phone: 405-609-3658