Oklahoma Physical Therapy Lawton Spine Care Sports Rehab LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

OKLAHOMA PHYSICAL THERAPY LAWTON SPINE CARE SPORTS REHAB LLC

Practice address

4645 W Gore Blvd
Suite E
Lawton, OK 73505-6041

Phone

(405) 749-6281

Fax

(405) 936-6496

NPI assigned

Jul 21, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lee Kara Nicole, PT

Title

Director

Phone

(405) 749-6281

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1124283064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4645 W GORE BLVD",
            "address_2": "SUITE E",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056041",
            "telephone_number": "405-749-6281",
            "fax_number": "405-936-6496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4645 W GORE BLVD",
            "address_2": "SUITE E",
            "city": "LAWTON",
            "state": "OK",
            "postal_code": "735056041",
            "telephone_number": "405-749-6281",
            "fax_number": "405-936-6496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKLAHOMA PHYSICAL THERAPY LAWTON SPINE CARE SPORTS REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-21",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "NICOLE",
        "authorized_official_first_name": "LEE",
        "authorized_official_middle_name": "KARA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "405-749-6281",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Oklahoma Emergency Services PC
• Oklahoma Mental Health Council
• Oklahoma State Department of Health
• Oladipo Igbekoyi MD PLLC
• Folake Esther Olaosebikan, MBBS
• Victor Olivencia, CBHCM-DC
• Kaitlin Oliver, DO

• All providers in Lawton, OK
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.