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Organization

GENESIS REHABILITATION AND CONDITIONING, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY SCOTT ISCH P.T. (PRESIDENT)
(405) 752-1913
Entity
Organization

Contact information

Practice address
9650 N MAY AVE, OKLAHOMA CITY, OK 73120-2714
(405) 752-1913
(405) 755-5426
Mailing address
9650 N MAY AVE, OKLAHOMA CITY, OK 73120-2714
(405) 752-1913
(405) 755-5426

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
2183
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
144729564
INDIVIDUAL NPI
OK
Enumeration date
03/04/2012
Last updated
12/19/2012
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