Provider Demographics
NPI:1477705879
Name:DURANT PHYSICAL THERAPY, INC
Entity Type:Organization
Organization Name:DURANT PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRADLEY
Authorized Official - Middle Name:N
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:580-920-2231
Mailing Address - Street 1:1004 N 19TH AVE
Mailing Address - Street 2:BLDG 4
Mailing Address - City:DURANT
Mailing Address - State:OK
Mailing Address - Zip Code:74701-3016
Mailing Address - Country:US
Mailing Address - Phone:580-920-2231
Mailing Address - Fax:580-920-2242
Practice Address - Street 1:1004 N 19TH AVE
Practice Address - Street 2:BLDG 4
Practice Address - City:DURANT
Practice Address - State:OK
Practice Address - Zip Code:74701-3016
Practice Address - Country:US
Practice Address - Phone:580-920-2231
Practice Address - Fax:580-920-2242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-16
Last Update Date:2008-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK171225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty