Basic Information
| Provider Information | |||||||||
| NPI: | 1194860544 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PHYSICAL THERAPY CENTRAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 923 N ROBINSON AVE FL 1 | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731025845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052315800 | ||||||||
| FaxNumber: | 4052314200 | ||||||||
| Practice Location | |||||||||
| Address1: | 923 N ROBINSON AVE FL 1 | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | OKLAHOMA CITY | ||||||||
| State: | OK | ||||||||
| PostalCode: | 731025845 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4052315800 | ||||||||
| FaxNumber: | 4052314200 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/21/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | FINLEY | ||||||||
| AuthorizedOfficialFirstName: | BRIDGIT | ||||||||
| AuthorizedOfficialMiddleName: | ANN | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER, PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 4055791600 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT, DPT, MED, OCS | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 2959 | OK | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
ID Information
| ID | Type | State | Issuer | Description | 2959 | 01 | OK | OK STATE PT LICENSE | OTHER |