Healthcare Provider Details

I. General information

NPI: 1548644420
Provider Name (Legal Business Name): GUNTHER CHIROPRACTIC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2015
Last Update Date: 07/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2518 E KENOSHA ST
BROKEN ARROW OK
74014-6712
US

IV. Provider business mailing address

2518 E KENOSHA ST
BROKEN ARROW OK
74014-6712
US

V. Phone/Fax

Practice location:
  • Phone: 918-286-2729
  • Fax: 918-286-0651
Mailing address:
  • Phone: 918-286-2729
  • Fax: 918-286-0651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. ANDREW JAMES GUNTHER
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 517-303-9780