Provider Demographics
NPI:1164537262
Name:OKC PHYSICAL THERAPY SOUTH
Entity Type:Organization
Organization Name:OKC PHYSICAL THERAPY SOUTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HORSCH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, OCS
Authorized Official - Phone:405-691-3200
Mailing Address - Street 1:9913 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-6920
Mailing Address - Country:US
Mailing Address - Phone:405-691-3200
Mailing Address - Fax:405-691-3204
Practice Address - Street 1:9913 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6920
Practice Address - Country:US
Practice Address - Phone:405-691-3200
Practice Address - Fax:405-691-3204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK#PT1200261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy