Provider Demographics
| NPI: | 1164052148 |
|---|---|
| Name: | MARLOW REHAB SERVICES, PLLC |
| Entity type: | Organization |
| Organization Name: | MARLOW REHAB SERVICES, PLLC |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CO-OWNER/PHYSICAL THERAPIST |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | ROBERT |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | RAINES |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PT |
| Authorized Official - Phone: | 405-650-7531 |
| Mailing Address - Street 1: | PO BOX 532 |
| Mailing Address - Street 2: | |
| Mailing Address - City: | MARLOW |
| Mailing Address - State: | OK |
| Mailing Address - Zip Code: | 73055-0532 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 405-650-7531 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 304 W. GILKEY |
| Practice Address - Street 2: | |
| Practice Address - City: | MARLOW |
| Practice Address - State: | OK |
| Practice Address - Zip Code: | 73055-1224 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 580-641-0030 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2020-01-18 |
| Last Update Date: | 2020-03-11 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QP2000X | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | |
| No | 2255A2300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Specialist/Technologist | Athletic Trainer | Group - Multi-Specialty |
| No | 225X00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist | Group - Multi-Specialty | |
| No | 224Z00000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapy Assistant | Group - Multi-Specialty | |
| No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
| No | 2251S0007X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Sports | Group - Multi-Specialty |
| No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |
| No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty |
