Healthcare Provider Details

I. General information

NPI: 1508742974
Provider Name (Legal Business Name): SMITH CHIROPRACTIC, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 S TELEPHONE RD STE 150
MOORE OK
73160-2972
US

IV. Provider business mailing address

2900 S TELEPHONE RD STE 150
MOORE OK
73160-2972
US

V. Phone/Fax

Practice location:
  • Phone: 405-793-8777
  • Fax: 405-793-1089
Mailing address:
  • Phone: 405-793-8777
  • Fax: 405-793-1089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: GREGORY ALLAN SMITH
Title or Position: OPERATING MANAGER
Credential: DC
Phone: 405-793-8777