Organization
COMANCHE COUNTY HOSPITAL AUTHORITY
Active
Other names
Lawton Physical Therapy & Sports Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RANDALL K. SEGLER (CEO)
(580) 585-5511
Entity
Organization
Contact information
Practice address
602 SE WALLOCK ST, LAWTON, OK 73501-5444
(580) 355-1512
(580) 355-1513
Mailing address
PO BOX 129, LAWTON, OK 73502-0129
(580) 355-8620
(580) 250-6458
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
2237
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000370056001
BLUE CROSS BLUE SHIELD
—
Enumeration date
10/09/2006
Last updated
08/22/2020
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