Southwestern Sports & Industrial Rehab Clinc Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

703 Issued in OK

Legal business name

SOUTHWESTERN SPORTS & INDUSTRIAL REHAB CLINC INC

Practice address

1400 Lera
Weatherford, OK 73096-2629

Phone

(580) 772-3200

Fax

(580) 772-1061

NPI assigned

Oct 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jimmy Drake Alexander

Title

Director

Phone

(580) 772-3200

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1255414298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 665",
            "address_2": "1400 LERA DR.",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730960665",
            "telephone_number": "580-772-3200",
            "fax_number": "580-772-1061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 LERA",
            "city": "WEATHERFORD",
            "state": "OK",
            "postal_code": "730962629",
            "telephone_number": "580-772-3200",
            "fax_number": "580-772-1061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWESTERN SPORTS & INDUSTRIAL REHAB CLINC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALEXANDER",
        "authorized_official_first_name": "JIMMY",
        "authorized_official_middle_name": "DRAKE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "580-772-3200",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "OK",
            "license": "703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cherilen Slagell, LPN
• Catheryn Ann Smith, M.ED. LPC
• Southwesten Oklahoma State University Training Room
• Southwestern Oklahoma State University (SWOSU Sports Medicine)
• Southwestern Oklahoma State University
• Amy Elizabeth Sparks, B.S.W.
• Crystal Speights
• Constance Spivey
• Morgan Marie Sprague, MS, LPC
• Ethan Springle

• Physical Therapist in Weatherford, OK
• Providers in Weatherford, OK by specialty
• Physical Therapist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.