Healthcare Provider Details

I. General information

NPI: 1821276304
Provider Name (Legal Business Name): TOUGAS CHIROPRACTIC CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2008
Last Update Date: 08/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 E RAY FINE BLVD SUITE #6
ROLAND OK
74954-5181
US

IV. Provider business mailing address

PO BOX 5437
FORT SMITH AR
72913-5437
US

V. Phone/Fax

Practice location:
  • Phone: 479-696-8697
  • Fax: 918-398-0637
Mailing address:
  • Phone: 479-696-8697
  • Fax: 918-398-0637

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: BERNARD MICHEAL TOUGAS JR.
Title or Position: PRESIDENT
Credential: DC
Phone: 479-696-8697