Organization
BRELAND HEALTH & REHAB GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BRENDA SUE BRELAND (MANAGER)
(940) 569-3630
Entity
Organization
Contact information
Practice address
1320 NW HOMESTEAD DR, STE E, LAWTON, OK 73505-5243
(580) 353-6300
(580) 353-6319
Mailing address
208 S RED RIVER EXPY, STE E, BURKBURNETT, TX 76354-3752
(940) 569-3630
(940) 569-3752
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
640900000
TX
225100000X
Physical Therapist
OK2429
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100835690A
—
OK
01
—
1008356996A
CRAIG MCBRIDE
—
05
—
167449101
—
TX
01
—
376591
OKLAHOMA MEDICARE
OK
Enumeration date
03/28/2007
Last updated
07/26/2011
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