Provider Demographics
NPI:1255473344
Name:HAPPY FEET LLC
Entity Type:Organization
Organization Name:HAPPY FEET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLOWERETTE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-287-1400
Mailing Address - Street 1:606 KIHEKAH AVE
Mailing Address - Street 2:
Mailing Address - City:PAWHUSKA
Mailing Address - State:OK
Mailing Address - Zip Code:74056-4225
Mailing Address - Country:US
Mailing Address - Phone:918-287-1400
Mailing Address - Fax:918-287-1814
Practice Address - Street 1:606 KIHEKAH AVE
Practice Address - Street 2:
Practice Address - City:PAWHUSKA
Practice Address - State:OK
Practice Address - Zip Code:74056-4225
Practice Address - Country:US
Practice Address - Phone:918-287-1400
Practice Address - Fax:918-287-1814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain MedicineGroup - Single Specialty