Provider Demographics
NPI:1033670492
Name:HYLAND PHYSICAL THERAPY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:HYLAND PHYSICAL THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HYLAND
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CEEAA
Authorized Official - Phone:918-251-7199
Mailing Address - Street 1:PO BOX 1678
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74013-1678
Mailing Address - Country:US
Mailing Address - Phone:918-251-7199
Mailing Address - Fax:539-777-2501
Practice Address - Street 1:2603 S 15TH PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7285
Practice Address - Country:US
Practice Address - Phone:918-251-7199
Practice Address - Fax:539-777-2501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-28
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy