Provider Demographics
NPI:1942260765
Name:HEALTH PARTNERS PT LLC
Entity Type:Organization
Organization Name:HEALTH PARTNERS PT LLC
Other - Org Name:PROMOTION PHYSICAL THERAPY
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ED
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-879-9997
Mailing Address - Street 1:801 NW 63RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-7603
Mailing Address - Country:US
Mailing Address - Phone:405-789-3397
Mailing Address - Fax:
Practice Address - Street 1:801 NW 63RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-7603
Practice Address - Country:US
Practice Address - Phone:405-879-9997
Practice Address - Fax:405-789-3397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-24
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKDF6029OtherRAILROAD MEDICARE ID