Provider Demographics
NPI:1225210370
Name:HUMAN PERFORMANCE CENTER 6 PC
Entity Type:Organization
Organization Name:HUMAN PERFORMANCE CENTER 6 PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:DAVISON
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-610-7800
Mailing Address - Street 1:9060 HARMONY DR STE A
Mailing Address - Street 2:
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-6253
Mailing Address - Country:US
Mailing Address - Phone:405-610-7800
Mailing Address - Fax:
Practice Address - Street 1:9060 HARMONY DR STE A
Practice Address - Street 2:
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-6253
Practice Address - Country:US
Practice Address - Phone:405-610-7800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-30
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT 2241261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy