Provider Demographics
NPI:1275839326
Name:R & S OPTIMAL REHAB LLC
Entity Type:Organization
Organization Name:R & S OPTIMAL REHAB LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-735-8777
Mailing Address - Street 1:1700 S BROADWAY ST
Mailing Address - Street 2:STE B
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-5300
Mailing Address - Country:US
Mailing Address - Phone:405-735-8777
Mailing Address - Fax:405-735-8778
Practice Address - Street 1:1700 S BROADWAY ST
Practice Address - Street 2:STE B
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-5300
Practice Address - Country:US
Practice Address - Phone:405-735-8777
Practice Address - Fax:405-735-8778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-08
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKOKPT3210261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy