Healthcare Provider Details

I. General information

NPI: 1053971598
Provider Name (Legal Business Name): GARRETT MICHAEL OKUN DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2019
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 S PLAZA WAY STE 150
FLAGSTAFF AZ
86001-7156
US

IV. Provider business mailing address

710 N BEAVER ST BLDG 3
FLAGSTAFF AZ
86001-3147
US

V. Phone/Fax

Practice location:
  • Phone: 928-226-1556
  • Fax: 855-821-1779
Mailing address:
  • Phone: 282-261-5569
  • Fax: 855-821-1779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHIR010224
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: