=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538495288
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | PRECISION THERAPY SERVICES, L.L.C.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/29/2009
-----------------------------------------------------
Last Update Date | 10/29/2009
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2600 VAN BUREN ST SUITE 2604
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73072-5640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-360-8172
-----------------------------------------------------
Fax | 405-360-8167
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2600 VAN BUREN ST SUITE 2604
-----------------------------------------------------
City | NORMAN
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73072-5640
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 405-360-8172
-----------------------------------------------------
Fax | 405-360-8167
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER & PRESIDENT
-----------------------------------------------------
Name | MR. ZACHARIAH LEE WELDON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 405-360-8172
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------