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NPI 1114135472

NPI 1114135472 : PERFORMAX PHYSICAL THERAPY, PLLC : NORMAN, OK

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General NPI Number Information
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    NPI Number           |    1114135472
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    Entity Type          |    Organization 
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    Legal Business Name  |    PERFORMAX PHYSICAL THERAPY, PLLC 
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Dates
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    Enumeration Date     |    05/19/2007
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    Last Update Date     |    08/22/2020
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Provider Practice Location Address
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    Address Line         |    3924 DURANGO CIR 
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    City                 |    NORMAN
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    State                |    OK
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    Zip                  |    73072-5028
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    Country              |    US
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    Telephone            |    405-604-1160
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3924 DURANGO CIR 
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    City                 |    NORMAN
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    State                |    OK
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    Zip                  |    73072-5028
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     KURT  STRAUGHN 
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    Credential           |    
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    Telephone            |    405-604-1160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QP2000X
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    Taxonomy Name        |    Physical Therapy Clinic/Center
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    License Number       |    
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    License Number State |    
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