Organization
CHOCTAW PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAWN G WALLACE PT, DPT (OWNER - PARTNER)
(405) 769-5555
Entity
Organization
Contact information
Practice address
13390 NE 23RD ST, CHOCTAW, OK 73020-8622
(405) 769-5555
(405) 769-5558
Mailing address
13390 NE 23RD ST, CHOCTAW, OK 73020-8622
(405) 769-5555
(405) 769-5558
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
09/21/2020
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