MEDICARE: R A CHIROPRACTIC SERVICES INC

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
1	111N00000X	Chiropractor	3085	OK

General Provider Information

NPI Number	:	1376811091
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	R A CHIROPRACTIC SERVICES INC

Provider Business Mailing Address
First Line	:	128 N OAKWOOD RD
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-4946
Country	:	US
Telephone Number	:	580-234-2700
Fax Number	:	580-234-3338

Provider Business Practice Location Address
First Line	:	128 N OAKWOOD RD
Second Line	:
City	:	ENID
State	:	OK
Zip	:	73703-4946
Country	:	US
Telephone Number	:	580-234-2700
Fax Number	:	580-234-3338

Authorized Official
Title or Position	:	OWNER
Name	:	DR. RONALD DEAN ANDERSON
Credential	:	D.C.
Telephone Number	:	580-234-2700

Provider Enumeration Date	:	12/08/2011
Last Update Date	:	12/08/2011

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Directions to “R A CHIROPRACTIC SERVICES INC ” Practice Location

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