Provider Demographics
NPI:1033514161
Name:HELFFRICH, COLBY
Entity Type:Individual
Prefix:
First Name:COLBY
Middle Name:
Last Name:HELFFRICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 MERCHANT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6470
Mailing Address - Country:US
Mailing Address - Phone:405-809-8710
Mailing Address - Fax:405-573-6768
Practice Address - Street 1:2103 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-9166
Practice Address - Country:US
Practice Address - Phone:580-225-0075
Practice Address - Fax:580-225-0095
Is Sole Proprietor?:No
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4892225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist