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General NPI Number Information
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NPI Number | 1740452630
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Entity Type | Organization
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Legal Business Name | THERAPIES FOR FUNCTION LLC
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Dates
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Enumeration Date | 03/31/2008
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Last Update Date | 03/05/2010
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Provider Practice Location Address
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Address Line | 1514 E 67TH CT
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City | TULSA
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State | OK
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Zip | 74136-3848
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Country | US
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Telephone | 918-521-4273
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Fax |
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Provider Business Mailing Address
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Address Line | 1514 E 67TH CT
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City | TULSA
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State | OK
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Zip | 74136-3848
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Country | US
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Telephone | 918-521-4273
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHELLE T MACKIN
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Credential | RPT
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Telephone | 918-521-4273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PT2382
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License Number State | OK
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