Organization
SOUTHEASTERN OKLAHOMA OUTPATIENT REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NANCY BARLOW (ADMINISTRATOR)
(903) 614-4402
Entity
Organization
Contact information
Practice address
1425 LINCOLN RD, SUITE B-3, IDABEL, OK 74745-7345
(580) 286-4842
(903) 735-5399
Mailing address
PO BOX 3070, TEXARKANA, TX 75504-3070
(903) 735-5356
(903) 735-5399
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
441764286001
BLUE CROSS
OK
Enumeration date
09/09/2005
Last updated
07/21/2022
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