Provider Demographics
NPI:1093096968
Name:LAU, GEOFFREY KU (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GEOFFREY
Middle Name:KU
Last Name:LAU
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34637 AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-8583
Mailing Address - Country:US
Mailing Address - Phone:405-238-7000
Mailing Address - Fax:405-238-7005
Practice Address - Street 1:34637 AIRLINE RD
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-8583
Practice Address - Country:US
Practice Address - Phone:405-238-7000
Practice Address - Fax:405-238-7005
Is Sole Proprietor?:No
Enumeration Date:2011-09-06
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4447225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist