Provider Demographics
NPI:1558776864
Name:PHYSICAL THERAPY CENTRAL JONES
Entity Type:Organization
Organization Name:PHYSICAL THERAPY CENTRAL JONES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:KOWARDY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-809-8710
Mailing Address - Street 1:12950 E BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:JONES
Mailing Address - State:OK
Mailing Address - Zip Code:73049-7400
Mailing Address - Country:US
Mailing Address - Phone:405-809-8650
Mailing Address - Fax:405-399-5512
Practice Address - Street 1:440 MERCHANT DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6470
Practice Address - Country:US
Practice Address - Phone:405-809-8710
Practice Address - Fax:405-573-6768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHYSICAL THERAPY CENTRAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-25
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4685225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty