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General NPI Number Information
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NPI Number | 1962829523
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Entity Type | Organization
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Legal Business Name | YUKON WOUND CARE AND REHABILITATION PLLC
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Dates
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Enumeration Date | 03/20/2014
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Last Update Date | 08/04/2014
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Provider Practice Location Address
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Address Line | 1808 COMMONS CIRCLE STE B
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City | YUKON
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State | OK
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Zip | 73099
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Country | US
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Telephone | 405-265-2255
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Fax | 405-265-2215
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Provider Business Mailing Address
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Address Line | 9604 S ALLEN DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73139-5303
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Country | US
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Telephone | 405-990-6023
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Fax | 405-265-2215
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Authorized Official
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Title or Position | OWNER
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Name | MRS. SHERRI D BOOS
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Credential |
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Telephone | 405-990-6023
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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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