Organization
DENNIS VENTURES INC
Active
Other names
KINETIC THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA E PRYOR (BILLING MANAGER)
(580) 371-8401
Entity
Organization
Contact information
Practice address
304 W MAIN ST, TISHOMINGO, OK 73460-1727
(580) 371-8401
(580) 371-8402
Mailing address
304 W MAIN ST, TISHOMINGO, OK 73460-1727
(580) 371-8401
(580) 371-8402
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT2326
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100834300A
—
OK
Enumeration date
11/09/2009
Last updated
11/24/2009
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