Organization
PREHAB PHYSICAL THERAPY CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RUTH M ROSS R.P.T. (PRESIDENT)
(580) 355-1766
Entity
Organization
Contact information
Practice address
2716 W GORE BLVD, SUITE D, LAWTON, OK 73505-6305
(580) 355-1766
(580) 357-8750
Mailing address
PO BOX 6626, LAWTON, OK 73506-0626
(580) 355-1766
(580) 357-8750
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
655
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
443560173001
BCBS
OK
Enumeration date
01/25/2007
Last updated
05/05/2010
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