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General NPI Number Information
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NPI Number | 1851434211
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Entity Type | Organization
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Legal Business Name | AZHAR THERAPY & FITNESS, INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 06/18/2015
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Provider Practice Location Address
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Address Line | 3410 NW 135TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-4009
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Country | US
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Telephone | 405-752-7377
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Fax | 405-752-7387
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Provider Business Mailing Address
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Address Line | 3410 NW 135TH ST
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-4009
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Country | US
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Telephone | 405-752-7377
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Fax | 405-752-7387
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. LISA ANN AZHAR
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Credential | PHYSICAL THERAPIST
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Telephone | 405-752-7377
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | PT2109
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License Number State | OK
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