Provider Demographics
NPI:1922185933
Name:AXIOM HEALTH INC
Entity type:Organization
Organization Name:AXIOM HEALTH INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:M
Authorized Official - Last Name:OWEN
Authorized Official - Suffix:
Authorized Official - Credentials:EP
Authorized Official - Phone:405-359-8717
Mailing Address - Street 1:12101 N MACARTHUR BLVD
Mailing Address - Street 2:# 214
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73162-1800
Mailing Address - Country:US
Mailing Address - Phone:405-359-8717
Mailing Address - Fax:405-359-8724
Practice Address - Street 1:11936 N MAY AVE
Practice Address - Street 2:SUITE 270
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-6808
Practice Address - Country:US
Practice Address - Phone:405-359-8717
Practice Address - Fax:405-359-8724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2996225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty