Organization
BESPOKE PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIKOLAUS PRESCOTT PT, DPT (OWNER)
(918) 841-6257
Entity
Organization
Contact information
Practice address
4907 E GALVESTON PL, BROKEN ARROW, OK 74014-2342
(918) 841-6257
(539) 399-7520
Mailing address
4907 E GALVESTON PL, BROKEN ARROW, OK 74014-2342
(918) 841-6257
(539) 399-7520
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
07/25/2024
Last updated
07/25/2024
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