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General NPI Number Information
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NPI Number | 1760154512
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Entity Type | Organization
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Legal Business Name | GUYMON PHYSICAL THERAPY AND WELLNESS PLLC
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Dates
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Enumeration Date | 09/30/2021
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 322 S DOUGLAS AVE
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City | BEAVER
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State | OK
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Zip | 73032
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Country | US
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Telephone | 580-527-1289
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Fax | 405-267-4963
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Provider Business Mailing Address
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Address Line | 322 S DOUGLAS AVE
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City | BEAVER
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State | OK
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Zip | 73032
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Country | US
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Telephone | 580-527-1289
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Fax |
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Authorized Official
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Title or Position | PTA
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Name | SARA WILLIAMS
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Credential | PTA
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Telephone | 580-527-1289
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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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