Healthcare Provider Details

I. General information

NPI: 1669683371
Provider Name (Legal Business Name): DR DEBORA K BALFOUR CHIROPRACTIC PHYSICIAN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 S PENNSYLVANIA
OKLAHOMA CITY OK
73159
US

IV. Provider business mailing address

8501 S PENNSYLVANIA AVE
OKLAHOMA CITY OK
73159-5206
US

V. Phone/Fax

Practice location:
  • Phone: 405-692-4885
  • Fax: 405-681-0903
Mailing address:
  • Phone: 405-692-4885
  • Fax: 405-681-0903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number20060126
License Number StateTX

VIII. Authorized Official

Name: DR. DEBORA KAY BALFOUR-SAUL
Title or Position: CHIROPRACTIC PHYSICIAN
Credential: D.C.
Phone: 405-692-4885