Organization
IGNITE SPORTS AND REHAB OF ARDMORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN MARK TREADWELL (CEO / OWNER)
(580) 490-3312
Entity
Organization
Contact information
Practice address
908 N ROCKFORD RD, SUITE C, ARDMORE, OK 73401-2540
(580) 490-3312
(580) 490-3318
Mailing address
908 N ROCKFORD RD, SUITE C, ARDMORE, OK 73401-2540
(580) 490-3312
(580) 490-3318
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
4555
OK
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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