Provider Demographics
NPI:1417367624
Name:WEST END PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:WEST END PHYSICAL THERAPY LLC
Other - Org Name:WEST END PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-350-3007
Mailing Address - Street 1:PO BOX 851100
Mailing Address - Street 2:DEPT 700
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73085-1100
Mailing Address - Country:US
Mailing Address - Phone:405-419-8444
Mailing Address - Fax:405-419-7797
Practice Address - Street 1:1485 HEALTH CENTER PKWY
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-6492
Practice Address - Country:US
Practice Address - Phone:405-350-3007
Practice Address - Fax:405-350-2116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-28
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3763225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty