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General NPI Number Information
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NPI Number | 1699318626
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Entity Type | Organization
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Legal Business Name | PELVIC CARE PHYSICAL THERAPY, LLC
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 3770 W ROBINSON ST STE 112
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City | NORMAN
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State | OK
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Zip | 73072-3641
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Country | US
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Telephone | 405-922-3563
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Fax |
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Provider Business Mailing Address
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Address Line | 1337 SW 83RD ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73159-5923
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Country | US
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Telephone | 405-922-3563
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | AMANDA ROOK
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Credential | PT, DPT
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Telephone | 405-922-3563
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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 |
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License Number State |
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