Healthcare Provider Details

I. General information

NPI: 1164616512
Provider Name (Legal Business Name): CHOICE CHIROPRACTIC & ACUPUNCTURE, P.L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2007
Last Update Date: 08/29/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8805 N 145TH EAST AVE STE. 103
OWASSO OK
74055-8529
US

IV. Provider business mailing address

8805 N 145TH EAST AVE STE. 103
OWASSO OK
74055-8529
US

V. Phone/Fax

Practice location:
  • Phone: 918-274-9299
  • Fax: 918-274-9220
Mailing address:
  • Phone: 918-274-9299
  • Fax: 918-274-9220

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number State

VIII. Authorized Official

Name: DR. HEATHER VAN WYHE
Title or Position: OWNER
Credential:
Phone: 918-274-9299