Provider Demographics
NPI: | 1164052148 |
---|---|
Name: | MARLOW REHAB SERVICES, PLLC |
Entity Type: | Organization |
Organization Name: | MARLOW REHAB SERVICES, PLLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CO-OWNER/PHYSICAL THERAPIST |
Authorized Official - Prefix: | |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | RAINES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PT |
Authorized Official - Phone: | 405-650-7531 |
Mailing Address - Street 1: | PO BOX 532 |
Mailing Address - Street 2: | |
Mailing Address - City: | MARLOW |
Mailing Address - State: | OK |
Mailing Address - Zip Code: | 73055-0532 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 405-650-7531 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 304 W. GILKEY |
Practice Address - Street 2: | |
Practice Address - City: | MARLOW |
Practice Address - State: | OK |
Practice Address - Zip Code: | 73055-1224 |
Practice Address - Country: | US |
Practice Address - Phone: | 580-641-0030 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2020-01-18 |
Last Update Date: | 2020-03-11 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | |
No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Multi-Specialty |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | Group - Multi-Specialty |
No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty |