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General NPI Number Information
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NPI Number | 1407101413
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Entity Type | Organization
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Legal Business Name | MARLOW THERAPY AND SPORTS REHAB SOLUTIONS, PLLC
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 07/16/2012
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Provider Practice Location Address
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Address Line | 911 N BROADWAY ST
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City | MARLOW
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State | OK
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Zip | 73055-1224
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Country | US
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Telephone | 405-650-7531
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Fax |
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Provider Business Mailing Address
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Address Line | 911 N BROADWAY ST
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City | MARLOW
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State | OK
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Zip | 73055-1224
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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 | PHYSICAL THERAPIST/OWNER
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Name | MR. ROBERT G. RAINES
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Credential | PT
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Telephone | 405-650-7531
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2005
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1618
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3809
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License Number State | OK
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