Organization
NORTHEASTERN PHYSICAL REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CARL BRENT SCOTT PT (PHYSICAL THERAPIST)
(918) 458-5115
Entity
Organization
Contact information
Practice address
2021 MAHANEY AVE STE 6, TAHLEQUAH, OK 74464-5795
(918) 458-5115
(918) 458-5119
Mailing address
2021 MAHANEY AVE STE 6, TAHLEQUAH, OK 74464-5795
(918) 458-5115
(918) 458-5119
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2083
OK
Other
Enumeration date
12/14/2011
Last updated
12/14/2011
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