Organization
FIRSTCARE REHABILITATION, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LONNIE BRAND HARTSELL (VICE-PRESIDENT)
(580) 323-1682
Entity
Organization
Contact information
Practice address
1725 S HIGHWAY 183, SUITE 100, CLINTON, OK 73601-9533
(580) 323-1682
(580) 323-1711
Mailing address
PO BOX 334, CLINTON, OK 73601-0334
(580) 323-1682
(580) 323-1711
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
PT2120
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100745510A
—
OK
Enumeration date
08/10/2005
Last updated
02/25/2016
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