Organization
SPECIALIZED PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MELISA L STOUT-HERRING PT (PHYSICAL THERAPIST)
(405) 751-9955
Entity
Organization
Contact information
Practice address
3333 W HEFNER ROAD, SUITE A, OKLAHOMA CITY, OK 73120
(405) 751-9955
(405) 751-9982
Mailing address
3333 W HEFNER ROAD, SUITE A, OKLAHOMA CITY, OK 73120
(405) 751-9955
(405) 751-9982
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DD8187
RAILROAD MEDICARE
—
Enumeration date
02/02/2006
Last updated
04/20/2008
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