Provider Demographics
NPI:1477233658
Name:HOLISTIC PHYSICAL THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:HOLISTIC PHYSICAL THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRON
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:405-399-0234
Mailing Address - Street 1:1331 N TRIPLE X RD
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-7988
Mailing Address - Country:US
Mailing Address - Phone:405-399-0234
Mailing Address - Fax:405-400-8749
Practice Address - Street 1:2100 HARPER ST
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-8055
Practice Address - Country:US
Practice Address - Phone:405-399-0234
Practice Address - Fax:405-405-9749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-21
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty