Provider Demographics
NPI:1386238814
Name:ECHO SPORTS PHYSICAL THERAPY
Entity type:Organization
Organization Name:ECHO SPORTS PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPY/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:CARLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-816-7075
Mailing Address - Street 1:1009 DRIVER LN
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-1823
Mailing Address - Country:US
Mailing Address - Phone:405-816-7075
Mailing Address - Fax:
Practice Address - Street 1:3825 NW 166TH ST STE D6
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-9240
Practice Address - Country:US
Practice Address - Phone:405-697-1732
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-25
Last Update Date:2023-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSportsGroup - Single Specialty