Healthcare Provider Details

I. General information

NPI: 1033122585
Provider Name (Legal Business Name): DAMON HOLT COFFMAN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1069 N HARRAH RD
HARRAH OK
73045-9692
US

IV. Provider business mailing address

PO BOX 739
HARRAH OK
73045-0739
US

V. Phone/Fax

Practice location:
  • Phone: 405-454-6400
  • Fax: 405-294-3338
Mailing address:
  • Phone: 405-454-6400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3668
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: