Organization
HEALTH AND REHAB CLINIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MADHAVI REDDY MUPPIDI M.D. (FOUNDER)
(580) 226-4400
Entity
Organization
Contact information
Practice address
1101 12TH AVE NW, SUITE # 100, ARDMORE, OK 73401-5736
(580) 226-4400
(580) 226-4410
Mailing address
1101 12TH AVE, NW, SUITE # 100, ARDMORE, OK 73401
(580) 226-4400
(580) 226-4410
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
22554
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02488974114
—
OK
05
—
100035370A
—
OK
Enumeration date
07/12/2006
Last updated
12/19/2007
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