VITALITY SPORTS PHYSICAL THERAPY, LLC


Address: 3841 Riverside Dr, Tulsa, OK 74105-3045
Phone: 9039187499

VITALITY SPORTS PHYSICAL THERAPY, LLC (NPI# 1942829700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942829700
Entity Type Organization
Organization Name VITALITY SPORTS PHYSICAL THERAPY, LLC
Practice Address 3841 Riverside Dr
Tulsa
OK 74105-3045
Practice Telephone 9039187499
Mailing Telephone 9039187499
Enumeration Date 2020-04-13
Last Update Date 2020-04-13
Authorized Official Name JUSTIN CORD DEMOSS (OWNER)
Authorized Official Telephone 9039187499
Authorized Official Credential PT, DPT, CSCS
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2000X Clinic/Center
Specialization: Physical Therapy
Ambulatory Health Care Facilities

Office Location

Street Address 3841 RIVERSIDE DR
City TULSA
State OK
Zip Code 74105-3045

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1881208817 Op Pharmacy LLC Pharmacy 2865 E. Skelly Dr., Ste 225, Tulsa, OK 74105 2020-09-08
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1629547286 Kealey Jordan Oliver Occupational Therapist 3223 E. 31st Steet, Tulsa, OK 74105 2018-11-13
1265915631 Jand. Inc. Eyewear Supplier (Equipment, not the service) 3516 S Peoria Ave, Tulsa, OK 74105 2018-09-12
1235635277 Brenda Kay Sanders Speech-Language Pathologist 4911 S Detroit Ave, Tulsa, OK 74105 2018-03-30
1417400771 Caroline Hunter Heineck Speech-Language Pathologist 3223 E. 31st St., Tulsa, OK 74105 2016-08-03
1437509544 Reliance Care Health Services LLP Home Health 5810 S. Peoria Avenue, Tulsa, OK 74105 2016-06-20
1578921748 Latisha Henderson Case Manager/Care Coordinator 3015 E. Skelly Drive, Suite 103, Tulsa, OK 74105 2016-02-03
1326424573 Evelyn J Fennell Nurse's Aide 1143 E 57th Place, Tulsa, OK 74105 2015-08-10
1255717757 Rebecca Ann Hughes Dentist 3150 E 41st St Ste 131, Tulsa, OK 74105 2015-08-06
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Taxonomy Information

Taxonomy Code 261QP2000X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Physical Therapy

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1851918353 Doctorgthept, LLC Clinic/Center 6038 E 57th Street, Tulsa, OK 74135-8125 2020-06-30
1619357852 Recover LLC Clinic/Center 2504 E 14th Pl, Tulsa, OK 74104-4607 2015-06-03
1508006255 Therapy Plus Rehabilitation Inc Clinic/Center 5226 E 69th Pl, Tulsa, OK 74136-3407 2009-02-20
1578727939 Occupational Health Center of The Southwest, P.a. Clinic/Center 3900 N. Mingo Rd, Tulsa, OK 74116 2008-07-15
1952428930 Occupational Health Centers of The Southwest, P.a. Clinic/Center 9515 E. 51st Street, Suite G, Tulsa, OK 74145 2007-03-23
1477670552 Occupational Health Centers of The Southwest, P.a. Clinic/Center 5682 W. Skelly Drive, Tulsa, OK 74107 2007-03-23
1356404313 Oklahoma Physical Therapy Clinic/Center 10915 E 31st St, B12, Tulsa, OK 74146-1745 2006-12-19
1457375214 Physical Rehabilitation Center Inc. Clinic/Center 5577 S Lewis Ave, Tulsa, OK 74105-7132 2006-07-26
1316986722 Mobile Cardiac Imaging, LLC Clinic/Center 7018 S Utica Ave, Tulsa, OK 74136-3907 2006-06-05
1952817603 Pelvic Pt Consultants LLC Clinic/Center 6767 S Yale Ave Ste B, Tulsa, OK 74136-3302 2017-12-18
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Competitor

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City TULSA
Zip Code 74105

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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