Healthcare Provider Details

I. General information

NPI: 1003735002
Provider Name (Legal Business Name): GENERATIONS BRAIN & SPINE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1472 N MUSTANG RD
MUSTANG OK
73064-7214
US

IV. Provider business mailing address

9225 S CEMETERY RD
MUSTANG OK
73064-9313
US

V. Phone/Fax

Practice location:
  • Phone: 405-256-6806
  • Fax:
Mailing address:
  • Phone: 405-933-1707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. CASE JEFFERY WOODARD
Title or Position: CHIROPRACTOR
Credential: DC
Phone: 405-933-1707