Provider Demographics
NPI:1760254700
Name:JOURNEY WELL PHYSICAL THERAPY
Entity Type:Organization
Organization Name:JOURNEY WELL PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WEST
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:405-517-6343
Mailing Address - Street 1:8712 S 77TH EAST PL
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4878
Mailing Address - Country:US
Mailing Address - Phone:405-517-6343
Mailing Address - Fax:
Practice Address - Street 1:8712 S 77TH EAST PL
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4878
Practice Address - Country:US
Practice Address - Phone:405-517-6343
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy