MEDICARE: THERAPY PLUS REHABILITATION INC

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	4189	OK

General Provider Information

NPI Number	:	1508006255
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPY PLUS REHABILITATION INC

Provider Business Mailing Address
First Line	:	5226 E 69TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-3407
Country	:	US
Telephone Number	:	918-392-7007
Fax Number	:

Provider Business Practice Location Address
First Line	:	5226 E 69TH PL
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-3407
Country	:	US
Telephone Number	:	918-392-7007
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. SAMSON OLATUNJI ISOLA
Credential	:	DPT
Telephone Number	:	91893927007

Provider Enumeration Date	:	02/20/2009
Last Update Date	:	09/10/2010

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