Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Boomer 06, PLLC

Organization Physical Therapist · NPI 1871126383

Boomer 06, PLLC is a Physical Therapist in Oklahoma City, Oklahoma. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
2
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

10921 S Western Ave Ste 200
Oklahoma City, OK 73170-6228
Phone: (405) 996-0660
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Durable Medical Equipment & Medical Supplies Taxonomy 332B00000X

Record details

NPI number1871126383
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ryan Elassal — Physical Therapist · (405) 996-0660
Other names The Mobile Therapy Group; The Mobile Therapy Group
NPI enumeratedFebruary 13, 2020
Last updated in NPPESOctober 22, 2024
Certification dateOctober 22, 2024
Mailing address10921 S Western Ave Ste 200, Oklahoma City, OK 73170-6228

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