Provider Demographics
NPI:1063707875
Name:PRO THERAPY SERVICES LLC
Entity type:Organization
Organization Name:PRO THERAPY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:CHAFFEE
Authorized Official - Suffix:II
Authorized Official - Credentials:PT
Authorized Official - Phone:405-608-4308
Mailing Address - Street 1:3705 NW 63RD ST
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1935
Mailing Address - Country:US
Mailing Address - Phone:405-608-4308
Mailing Address - Fax:
Practice Address - Street 1:3705 NW 63RD ST
Practice Address - Street 2:SUITE 208
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1935
Practice Address - Country:US
Practice Address - Phone:405-608-4308
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3454225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty