Provider Demographics
NPI:1285061606
Name:OKLAHOMA PHYSICAL THERAPY CHOCTAW
Entity type:Organization
Organization Name:OKLAHOMA PHYSICAL THERAPY CHOCTAW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARA
Authorized Official - Middle Name:N
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-749-6281
Mailing Address - Street 1:PO BOX 680
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-0680
Mailing Address - Country:US
Mailing Address - Phone:405-281-5785
Mailing Address - Fax:405-936-6496
Practice Address - Street 1:1716 HARPER ST
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-8008
Practice Address - Country:US
Practice Address - Phone:405-281-5785
Practice Address - Fax:405-281-5786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-30
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3512418726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty