Organization
INTEGRIS SOUTH OKLAHOMA CITY CORPORATION
Active
Other names
Integris Jim Thorpe Outpatient Rehab South
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY HUPFELC (PRESIDENT/CEO)
(405) 949-6066
Entity
Organization
Contact information
Practice address
4100 S DOUGLAS AVE, OKLAHOMA CITY, OK 73109-3210
(405) 644-5445
Mailing address
5400 N INDEPENDENCE AVE, 100, OKLAHOMA CITY, OK 73112-5300
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
2289
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100700200A
—
OK
Enumeration date
07/26/2006
Last updated
05/14/2008
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