Provider Demographics
NPI:1629013453
Name:TULSA ERGONOMIC CONSULTANTS, PLLC
Entity Type:Organization
Organization Name:TULSA ERGONOMIC CONSULTANTS, PLLC
Other - Org Name:THERAPY CONCEPTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MGR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:A
Authorized Official - Last Name:CYR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-712-8412
Mailing Address - Street 1:2417 E 53 ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6601
Mailing Address - Country:US
Mailing Address - Phone:918-712-8412
Mailing Address - Fax:918-712-8413
Practice Address - Street 1:2417 E 53 ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6601
Practice Address - Country:US
Practice Address - Phone:918-712-8412
Practice Address - Fax:918-712-8413
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TULSA ERGONOMIC CONSULTANTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-06-17
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3731225100000X
OK411225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200063060AMedicaid
OK200063060AMedicaid