Provider Demographics
NPI:1912296591
Name:ELIZABETH B. PARKHURST, P.T.
Entity type:Organization
Organization Name:ELIZABETH B. PARKHURST, P.T.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:B
Authorized Official - Last Name:PARKHURST
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:580-327-0732
Mailing Address - Street 1:PO BOX 862
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-0862
Mailing Address - Country:US
Mailing Address - Phone:580-327-0732
Mailing Address - Fax:580-327-0737
Practice Address - Street 1:427 BARNES AVE
Practice Address - Street 2:STE. 2
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-2287
Practice Address - Country:US
Practice Address - Phone:580-327-0732
Practice Address - Fax:580-327-0737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK546225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty