Organization
HOLISTIC THERAPY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL ALLEN PHILLIPS COTA/L (MANAGER / OWNER)
(405) 609-7566
Entity
Organization
Contact information
Practice address
2316 SANTA FE TER, EDMOND, OK 73012-4450
(405) 609-7566
(405) 330-4846
Mailing address
2316 SANTA FE TER, EDMOND, OK 73012-4450
(405) 609-7566
(405) 330-4846
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
COTA/L
OK
225100000X
Physical Therapist
PHYSICAL THERAPIST
OK
225200000X
Physical Therapy Assistant
PTA
OK
225X00000X
Occupational Therapist
Primary
OCCUPATIONAL THERAPY
OK
Other
Enumeration date
09/20/2007
Last updated
09/20/2007
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