Healthcare Provider Details

I. General information

NPI: 1770678138
Provider Name (Legal Business Name): GREGORY SCOTT HOWARD D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 SOUTH MAIN STREET
FREDERICK OK
73542
US

IV. Provider business mailing address

P.O. BOX 216
FREDERICK OK
73542-0216
US

V. Phone/Fax

Practice location:
  • Phone: 580-335-7373
  • Fax:
Mailing address:
  • Phone: 580-335-7373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3272
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: