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General NPI Number Information
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NPI Number | 1962621227
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Entity Type | Organization
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Legal Business Name | IN-HOME THERAPY, INC
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 06/15/2008
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Provider Practice Location Address
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Address Line | 9211 N 139TH EAST AVE
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City | OWASSO
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State | OK
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Zip | 74055-4593
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Country | US
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Telephone | 918-638-7464
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Fax |
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Provider Business Mailing Address
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Address Line | 9211 N 139TH EAST AVE
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City | OWASSO
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State | OK
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Zip | 74055-4593
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JAY D BRUMBAUGH
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Credential | PT
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Telephone | 918-638-7464
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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 | 2729
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License Number State | OK
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