Organization Name: | GRAND SLAM REHABILITATION L.L.C. |
NPI Number: | 1073560942 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEREK PRENTICE (MANAGING MEMBER) |
Mailing Address: | 6510 S Western Ave Suite 400 Oklahoma City |
State: | OK US |
Postal Code: | 731391712 |
Phone Number: | 4056318888 |
Fax Number: | 4056319593 |
NPI Enumeration Date: | 05/27/2006 |
NPI Last Update Date: | 03/09/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |