Provider Demographics
NPI:1790924637
Name:QUALITY THERAPY CENTER LLC
Entity Type:Organization
Organization Name:QUALITY THERAPY CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:POYER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-301-3435
Mailing Address - Street 1:PO BOX 178
Mailing Address - Street 2:
Mailing Address - City:NEWALLA
Mailing Address - State:OK
Mailing Address - Zip Code:74857-0178
Mailing Address - Country:US
Mailing Address - Phone:405-610-3048
Mailing Address - Fax:405-610-3049
Practice Address - Street 1:8855 EAST RENO AVENUE
Practice Address - Street 2:#212
Practice Address - City:MIDWEST CITY,
Practice Address - State:OK
Practice Address - Zip Code:73110-7732
Practice Address - Country:US
Practice Address - Phone:405-610-3048
Practice Address - Fax:405-610-3049
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-17
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty