Provider Demographics
NPI:1104816826
Name:THERAPY LINKS PHYSICAL REHABILITATION PLLC
Entity type:Organization
Organization Name:THERAPY LINKS PHYSICAL REHABILITATION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HALF OWNER OF CLINIC MEMBER PLLC
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:COFFMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS OTRL
Authorized Official - Phone:918-622-1242
Mailing Address - Street 1:PO BOX 33223
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74153-1223
Mailing Address - Country:US
Mailing Address - Phone:918-622-1242
Mailing Address - Fax:918-622-1291
Practice Address - Street 1:3946 S HUDSON AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5608
Practice Address - Country:US
Practice Address - Phone:918-622-1242
Practice Address - Fax:918-622-1291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-25
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherTRICARE
OK=========001OtherBCBS