Healthcare Provider Details

I. General information

NPI: 1609321223
Provider Name (Legal Business Name): HELIX INTEGRATED HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2016
Last Update Date: 08/24/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9402 N MAY AVE
OKLAHOMA CITY OK
73120-2701
US

IV. Provider business mailing address

PO BOX 20328
OKLAHOMA CITY OK
73156-0328
US

V. Phone/Fax

Practice location:
  • Phone: 405-537-5665
  • Fax:
Mailing address:
  • Phone: 405-537-5665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number4156
License Number StateOK

VIII. Authorized Official

Name: DR. ROY HANSEN
Title or Position: OWNER
Credential: D.C.
Phone: 405-537-5665