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NPI Code Detail

MEDICARE: GEOFFREY KU LAU PT, DPT

MEDICARE: GEOFFREY KU LAU PT, DPT
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
1225100000XPhysical Therapist4447OK

General Provider Information

NPI Number : 1093096968
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEOFFREY KU LAU PT, DPT
Provider Business Mailing Address
First Line : 34637 AIRLINE RD
Second Line :
City : PAULS VALLEY
State : OK
Zip : 73075-8583
Country : US
Telephone Number : 405-238-7000
Fax Number : 405-238-7005
Provider Business Practice Location Address
First Line : 34637 AIRLINE RD
Second Line :
City : PAULS VALLEY
State : OK
Zip : 73075-8583
Country : US
Telephone Number : 405-238-7000
Fax Number : 405-238-7005
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 06/12/2013

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