Provider Demographics
NPI:1689950537
Name:TOTAL THERAPY PLLC
Entity Type:Organization
Organization Name:TOTAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:GOLDSMITH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:580-564-0549
Mailing Address - Street 1:717C HIGHWAY 70 E
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:OK
Mailing Address - Zip Code:73439-8253
Mailing Address - Country:US
Mailing Address - Phone:580-564-0549
Mailing Address - Fax:580-564-1979
Practice Address - Street 1:717C HIGHWAY 70 E
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:OK
Practice Address - Zip Code:73439-8253
Practice Address - Country:US
Practice Address - Phone:580-564-0549
Practice Address - Fax:580-564-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4122225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1962663419Medicare PIN