Provider Demographics
NPI:1811146111
Name:THERAPY SPECIALISTS, INC.
Entity type:Organization
Organization Name:THERAPY SPECIALISTS, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:A
Authorized Official - Last Name:STREICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:405-922-1860
Mailing Address - Street 1:416 W 15TH ST
Mailing Address - Street 2:BLDG 500-G
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-3672
Mailing Address - Country:US
Mailing Address - Phone:405-922-1860
Mailing Address - Fax:866-664-3806
Practice Address - Street 1:1420 MAIN ST
Practice Address - Street 2:
Practice Address - City:WOODWARD
Practice Address - State:OK
Practice Address - Zip Code:73801-3004
Practice Address - Country:US
Practice Address - Phone:580-254-9111
Practice Address - Fax:866-359-3370
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-11
Last Update Date:2013-01-18
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
OK200225130 AMedicaid
OK200225130 AMedicaid