Healthcare Provider Details

I. General information

NPI: 1841996931
Provider Name (Legal Business Name): DACEY HUTCHESON DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 02/01/2023
Certification Date: 02/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

481 MERCHANT DR
NORMAN OK
73069-6565
US

IV. Provider business mailing address

1305 MEDINAH DR
SHAWNEE OK
74801-0528
US

V. Phone/Fax

Practice location:
  • Phone: 405-450-4616
  • Fax:
Mailing address:
  • Phone: 405-760-3172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License Number4521
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: