Healthcare Provider Details

I. General information

NPI: 1336332378
Provider Name (Legal Business Name): LEPIEN CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2007
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202B S BROADWAY ST
MARLOW OK
73055-3864
US

IV. Provider business mailing address

1202B S BROADWAY ST
MARLOW OK
73055-3864
US

V. Phone/Fax

Practice location:
  • Phone: 580-658-1042
  • Fax: 580-658-5312
Mailing address:
  • Phone: 580-658-1042
  • Fax: 580-658-5312

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2660
License Number StateOK

VIII. Authorized Official

Name: DR. MICHAEL A. LEPIEN SR.
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 580-658-1042