Healthcare Provider Details

I. General information

NPI: 1215001847
Provider Name (Legal Business Name): CHIROPRACTIC ARTS CENTER OF MOORE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 06/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

804 NE 23RD ST
MOORE OK
73160-8976
US

IV. Provider business mailing address

804 NE 23RD ST
MOORE OK
73160-8976
US

V. Phone/Fax

Practice location:
  • Phone: 405-794-5000
  • Fax: 405-794-5003
Mailing address:
  • Phone: 405-794-5000
  • Fax: 405-794-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3587
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3248
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1616
License Number StateOK
# 4
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3639
License Number StateOK

VIII. Authorized Official

Name: DR. KYLE WHITTEN MUSE
Title or Position: OWNER
Credential: DC
Phone: 405-794-5000