| Organization Name: | OKLA REHAB PULMONARY SPECIALIST |
| NPI Number: | 1114179090 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | BOBBY DANIEL (PRESIDENT) |
| Mailing Address: | 10 Plaza South Tahlequah |
| State: | OK US |
| Postal Code: | 74464 |
| Phone Number: | 9184889992 |
| Fax Number: | |
| NPI Enumeration Date: | 10/22/2008 |
| NPI Last Update Date: | 11/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0401X |
| License Number: | OK1843 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| Taxonomy Definition: | |