MEDICARE: ERGONOMIC CONSULTANTS, LLC

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	225100000X	Physical Therapist	PT1824	OK
2	225X00000X	Occupational Therapist	1411	OK
3	261QM1300X	Multi-Specialty Clinic/Center

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	700522190	OTHER	OK	MEDICARE PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1922039882
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ERGONOMIC CONSULTANTS, LLC

Provider Business Mailing Address
First Line	:	1309 E WADE WATTS AVE
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-5658
Country	:	US
Telephone Number	:	918-423-2220
Fax Number	:	918-423-2620

Provider Business Practice Location Address
First Line	:	1309 E WADE WATTS AVE
Second Line	:
City	:	MCALESTER
State	:	OK
Zip	:	74501-5658
Country	:	US
Telephone Number	:	918-423-2220
Fax Number	:	918-423-2620

Authorized Official
Title or Position	:	DIRECTOR OF OPERATIONS - CLINICS
Name	:	BRENDA KEMLING
Credential	:
Telephone Number	:	402-334-1919

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	05/23/2025

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