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General NPI Number Information
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NPI Number | 1477705879
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Entity Type | Organization
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Legal Business Name | DURANT PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 10/16/2008
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Last Update Date | 10/16/2008
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Provider Practice Location Address
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Address Line | 1004 N 19TH AVE BLDG 4
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City | DURANT
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State | OK
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Zip | 74701-3016
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Country | US
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Telephone | 580-920-2231
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Fax | 580-920-2242
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Provider Business Mailing Address
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Address Line | 1004 N 19TH AVE BLDG 4
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City | DURANT
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State | OK
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Zip | 74701-3016
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Country | US
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Telephone | 580-920-2231
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Fax | 580-920-2242
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Authorized Official
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Title or Position | OWNER/PHYSICAL THERAPIST
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Name | BRADLEY N HARPER
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Credential | PT
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Telephone | 580-920-2231
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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 | 171
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License Number State | OK
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