Organization
WONDERFULLY MADE THERAPY GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TINA NAIL PTA (PHYSICAL THERAPIST ASSISTANT, OWNER)
(918) 809-0101
Entity
Organization
Contact information
Practice address
211 E 7TH ST, OKMULGEE, OK 74447-4607
(918) 809-0101
Mailing address
8930 HILLTOP RD, BEGGS, OK 74421-2018
(918) 809-0101
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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