SOUTH TULSA PERFORMANCE HEALTH; NPI #1790969053

Contact Information

SOUTH TULSA PERFORMANCE HEALTH

7112 S MINGO RD STE 101
TULSA, OK 74133-3267

Phone: 918-949-6622
Fax: 918-872-9913
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Rehabilitation	261QR0400X	B4[14]	Rehabilitation Agency

Indicates primary specialty

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NPI Profile & details for SOUTH TULSA PERFORMANCE HEALTH

NPI Number 1790969053

LBN Legal business name SOUTH TULSA PERFORMANCE HEALTH

Authorized official JASON COOK - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 12/21/2007

Last updated 08/21/2008 - About 18 years ago

Identifiers

License #

3785

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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