Provider Demographics
NPI:1730132697
Name:HEALTHCARE MANAGEMENT GROUP OF LAWTON INC
Entity Type:Organization
Organization Name:HEALTHCARE MANAGEMENT GROUP OF LAWTON INC
Other - Org Name:THE THERAPY PLACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:GHOSN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-248-8481
Mailing Address - Street 1:4202 SW LEE BLVD
Mailing Address - Street 2:BLDG B, STE 204D
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-8300
Mailing Address - Country:US
Mailing Address - Phone:580-248-8481
Mailing Address - Fax:580-248-8996
Practice Address - Street 1:4202 SW LEE BLVD
Practice Address - Street 2:BLDG B, STE 204D
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73505-8300
Practice Address - Country:US
Practice Address - Phone:580-248-8481
Practice Address - Fax:580-248-8996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation