Healthcare Provider Details

I. General information

NPI: 1104531680
Provider Name (Legal Business Name): NATIVE CHIROPRACTIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/18/2023
Last Update Date: 01/18/2023
Certification Date: 01/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2237 W MEMORIAL RD STE 116
OKLAHOMA CITY OK
73134-8064
US

IV. Provider business mailing address

2237 W MEMORIAL RD STE 116
OKLAHOMA CITY OK
73134-8064
US

V. Phone/Fax

Practice location:
  • Phone: 405-534-4244
  • Fax: 405-543-1131
Mailing address:
  • Phone: 405-534-4244
  • Fax: 405-543-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DR. BRITTANY WETZEL
Title or Position: DOCTOR OF CHIROPRACTIC/ OWNER
Credential: DC
Phone: 405-534-4244