Anthony la Sorsa Physical Therapy, P.C.
Organization Active NPI Physical Therapy Clinic/Center · Lawton, OK
NPI 1083701221 · NPPES record last updated Dec 9, 2009
Key facts
- NPI
- 1083701221
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- License
- PT2929 (OK)
- Legal business name
- ANTHONY LA SORSA PHYSICAL THERAPY, P.C.
- Practice address
- 4417 W Gore Blvd Ste 14
Lawton, OK 73505-5978 - Phone
- (580) 353-9399
- Fax
- (580) 353-2624
- NPI assigned
- Oct 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Anthony Joseph La Sorsa, PT
- Title
- President/Physical Therapist
- Phone
- (580) 353-9399
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20061020000415 | OK | Part B Supplier - Clinic/Group Practice | 4082611777 |
Receives reassigned benefits from 1 practitioner Practice locations: Lawton, OK |
National Provider Directory
Locations
4417 W Gore Blvd
Ste 14
Lawton, OK 73505
Phone (580) 353-9399
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | PT2929 | OK | Yes |
Addresses
Primary practice location
4417 W Gore Blvd Ste 14
Lawton, OK 73505-5978
Mailing address
4417 W Gore Blvd Ste 14
Lawton, OK 73505-5978
Phone (580) 353-9399
Other providers in Lawton, OK
- Angela L. Stanley, LPC
- Tiffany Angell
- Ann Elizabeth Angiel
- Nadine Anglley
- Anthony Ferrara Chiropractic PC
- Anthony W. Layton
- Christopher Anthony
- Debra Antley
- Rebecca Aponte-Morales
- Ariah Anesthesia LLC
All providers in Lawton, OK · Physical Therapy Clinic/Center in Oklahoma
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.