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General NPI Number Information
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NPI Number | 1033438148
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Entity Type | Organization
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Legal Business Name | INDEPENDENT CONTRACT THERAPY SERVICES, LLC
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Dates
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Enumeration Date | 05/28/2010
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Last Update Date | 05/28/2010
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Provider Practice Location Address
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Address Line | 6048 S SHERIDAN RD SUITE B
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City | TULSA
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State | OK
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Zip | 74145-9212
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Country | US
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Telephone | 918-591-3897
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Fax | 918-591-3899
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Provider Business Mailing Address
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Address Line | 6048 S SHERIDAN RD SUITE B
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City | TULSA
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State | OK
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Zip | 74145-9212
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Country | US
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Telephone | 918-591-3897
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Fax | 918-591-3899
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Authorized Official
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Title or Position | REGISTERED AGENT OF COMPANY
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Name | DAVID ARMSTRONG
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Credential | RPT
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Telephone | 918-402-7688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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