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General NPI Number Information
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NPI Number | 1952742389
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Entity Type | Organization
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Legal Business Name | PH THERAPY HOLDINGS LLC
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 07/15/2013
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Provider Practice Location Address
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Address Line | 7040 S YALE AVE STE 750
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City | TULSA
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State | OK
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Zip | 74136
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Country | US
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Telephone | 580-276-6656
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Fax | 888-857-0023
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Provider Business Mailing Address
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Address Line | 7122 S SHERIDAN RD STE 2-564
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City | TULSA
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State | OK
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Zip | 74133
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Country | US
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Telephone | 580-276-6656
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Fax | 888-857-0023
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Authorized Official
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Title or Position | OWNER
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Name | PENNY HAUSSMANN
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Credential | MOT, OTR/L CLT
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Telephone | 580-276-6656
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 864
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License Number State | OK
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