Provider Demographics
NPI:1346247327
Name:KABRICK & ASSOCIATES, PC
Entity Type:Organization
Organization Name:KABRICK & ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KABRICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:918-664-6874
Mailing Address - Street 1:4147 E 49TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3217
Mailing Address - Country:US
Mailing Address - Phone:918-664-6874
Mailing Address - Fax:
Practice Address - Street 1:4147 E 49TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3217
Practice Address - Country:US
Practice Address - Phone:918-664-6874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-05
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100735510AMedicaid
OK100735510AMedicaid