Provider Demographics
NPI:1457507774
Name:HUMAN PERFORMANCE CENTER #8
Entity Type:Organization
Organization Name:HUMAN PERFORMANCE CENTER #8
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:CRISTINA
Authorized Official - Middle Name:HART
Authorized Official - Last Name:WOLFE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:580-323-7600
Mailing Address - Street 1:1221 W GARY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-2727
Mailing Address - Country:US
Mailing Address - Phone:580-323-7600
Mailing Address - Fax:
Practice Address - Street 1:1221 W GARY BLVD STE B
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-2727
Practice Address - Country:US
Practice Address - Phone:580-323-7600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty