Provider Demographics
NPI:1104995653
Name:ADVANCED OCCUPATIONAL REHABILITAION,INC
Entity type:Organization
Organization Name:ADVANCED OCCUPATIONAL REHABILITAION,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FARADAY
Authorized Official - Middle Name:
Authorized Official - Last Name:POUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-340-0462
Mailing Address - Street 1:2121 S COLUMBIA AVE STE 501
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74114-3513
Mailing Address - Country:US
Mailing Address - Phone:918-340-0462
Mailing Address - Fax:405-340-5432
Practice Address - Street 1:2121 S COLUMBIA AVE STE 501
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3513
Practice Address - Country:US
Practice Address - Phone:918-340-0462
Practice Address - Fax:405-340-5432
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2007-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports MedicineGroup - Multi-Specialty