Organization
PANHANDLE PHYSICAL THERAPY & WELLNESS, LLC
Active
Other names
Physical Therapy on the Move
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEREMY BEAU RAPP DPT (PHYSICAL THERAPIST)
(918) 346-0107
Entity
Organization
Contact information
Practice address
122 E GLAYDAS AVE, HOOKER, OK 73945-7394
(580) 652-1111
(580) 652-1111
Mailing address
102 S. BROADWAY, HOOKER, OK 73945
(580) 652-1111
(580) 652-1111
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200118240A
—
OK
01
—
OK400025
MEDICARE PTAN
OK
Enumeration date
08/21/2014
Last updated
04/12/2021
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