MEDICARE: OSSPT NW OKC PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1063130888
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OSSPT NW OKC PLLC

Provider Business Mailing Address
First Line	:	2422 NW 150TH ST UNIT 5
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-2031
Country	:	US
Telephone Number	:	405-735-8777
Fax Number	:	405-735-8778

Provider Business Practice Location Address
First Line	:	2422 NW 150TH ST UNIT 5
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-2031
Country	:	US
Telephone Number	:	405-735-8777
Fax Number	:	405-735-8778

Authorized Official
Title or Position	:	CO-OWNER
Name	:	JEFF FRAZIER
Credential	:	PT, DPT
Telephone Number	:	405-735-8777

Provider Enumeration Date	:	08/17/2022
Last Update Date	:	03/17/2026

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