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General NPI Number Information
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NPI Number | 1245672591
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Entity Type | Organization
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Legal Business Name | CL THERAPY INC.
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Dates
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Enumeration Date | 07/26/2013
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Last Update Date | 07/26/2013
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Provider Practice Location Address
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Address Line | 4166 COUNTY ROAD 1320
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City | CARNEGIE
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State | OK
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Zip | 73015-2270
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Country | US
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Telephone | 580-284-8853
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Fax | 580-654-2210
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Provider Business Mailing Address
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Address Line | 4166 COUNTY ROAD 1320
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City | CARNEGIE
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State | OK
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Zip | 73015-2270
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Country | US
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Telephone | 580-284-8853
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Fax | 580-654-2210
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Authorized Official
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Title or Position | OWNER/ CEO
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Name | CHRISTOPHER LAWRENCE
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Credential | P.T.A / CWTS/ CEASII
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Telephone | 580-284-8853
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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 | 1236
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License Number State | OK
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