Healthcare Provider Details

I. General information

NPI: 1760755193
Provider Name (Legal Business Name): ORTHOPAEDIC HOME CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2012
Last Update Date: 02/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2417 E 53RD ST
TULSA OK
74105-6601
US

IV. Provider business mailing address

2417 E 53RD ST
TULSA OK
74105-6601
US

V. Phone/Fax

Practice location:
  • Phone: 918-712-8400
  • Fax: 918-712-8413
Mailing address:
  • Phone: 918-712-8400
  • Fax: 918-712-8413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. MARK WINKELMANN
Title or Position: PRICNIPAL OFFICER
Credential: RPT
Phone: 918-712-8400