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NPI Code Detail

MEDICARE: MEDE, LLC

MEDICARE: MEDE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor3629OK

General Provider Information

NPI Number : 1316131139
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDE, LLC
Provider Business Mailing Address
First Line : 5508 S LEWIS AVE
Second Line :
City : TULSA
State : OK
Zip : 74105-7105
Country : US
Telephone Number : 918-259-3000
Fax Number : 918-259-3002
Provider Business Practice Location Address
First Line : 5508 S LEWIS AVE
Second Line :
City : TULSA
State : OK
Zip : 74105-7105
Country : US
Telephone Number : 918-259-3000
Fax Number : 918-259-3002
Authorized Official
Title or Position : OWNER
Name : DR. MICHAEL K VAN ANTWERP
Credential : DC
Telephone Number : 918-259-3000
Provider Enumeration Date : 09/05/2007
Last Update Date : 10/21/2021

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Directions to “MEDE, LLC ” Practice Location

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