Healthcare Provider Details

I. General information

NPI: 1073421749
Provider Name (Legal Business Name): HARLEY COUNTZ DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

215 W CARL ALBERT PKWY
MCALESTER OK
74501-4470
US

IV. Provider business mailing address

4964 STATE HIGHWAY 113
MCALESTER OK
74501-8544
US

V. Phone/Fax

Practice location:
  • Phone: 918-505-2962
  • Fax: 918-505-2962
Mailing address:
  • Phone: 918-421-9297
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number4734
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number4734
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: