| Organization Name: | PENNEY REHAB AND WELLNESS CENTER, LLC |
| NPI Number: | 1497006456 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEPHEN JOHN PENNEY (DIRECTOR) |
| Mailing Address: | 1004 S Broadway St Coalgate |
| State: | OK US |
| Postal Code: | 745382662 |
| Phone Number: | 5809279121 |
| Fax Number: | 8887800916 |
| NPI Enumeration Date: | 09/30/2012 |
| NPI Last Update Date: | 09/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 2868 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OK |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |