Healthcare Provider Details

I. General information

NPI: 1265653901
Provider Name (Legal Business Name): BROOKLINE CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1809 S DIVISION ST
GUTHRIE OK
73044-6061
US

IV. Provider business mailing address

1809 S DIVISION ST
GUTHRIE OK
73044-6061
US

V. Phone/Fax

Practice location:
  • Phone: 405-293-9345
  • Fax: 405-293-9347
Mailing address:
  • Phone: 405-293-9345
  • Fax: 405-293-9347

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3412
License Number StateOK

VIII. Authorized Official

Name: DR. TERRILL S FRAZEE
Title or Position: DOCTOR OWNER
Credential: D.C.
Phone: 405-293-9345