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General NPI Number Information
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NPI Number | 1962029967
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Entity Type | Organization
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Legal Business Name | PEDIATRIC PHYSICAL THERAPY OF BARTLESVILLE
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 548 SE WASHINGTON BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8231
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Country | US
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Telephone | 816-217-2976
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Fax |
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Provider Business Mailing Address
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Address Line | 548 SE WASHINGTON BLVD
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City | BARTLESVILLE
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State | OK
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Zip | 74006-8231
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Country | US
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Telephone | 816-217-2976
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHYSICAL THERAPIST
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Name | MRS. HEATHER L WILLIAMS
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Credential | PT
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Telephone | 816-217-2976
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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