Provider Demographics
NPI:1124037197
Name:LANG, ERNESTO EDUARDO (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:ERNESTO
Middle Name:EDUARDO
Last Name:LANG
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Other - First Name:
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Mailing Address - Street 1:2209 SW 74TH ST
Mailing Address - Street 2:SUITE # 320
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-3929
Mailing Address - Country:US
Mailing Address - Phone:405-686-6011
Mailing Address - Fax:405-686-1608
Practice Address - Street 1:2209 SW 74TH ST
Practice Address - Street 2:SUITE # 320
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-3929
Practice Address - Country:US
Practice Address - Phone:405-686-6011
Practice Address - Fax:405-686-1608
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OKPT1912225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist