Healthcare Provider Details

I. General information

NPI: 1215074174
Provider Name (Legal Business Name): FIELD & FIELD CHIROPRACTIC CLINIC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 W UNIVERSITY AVE 615 WEST UNIVERSITY AVENUE
STILLWATER OK
74074-3034
US

IV. Provider business mailing address

615 W UNIVERSITY AVE 615 WEST UNIVERSITY AVENUE
STILLWATER OK
74074-3034
US

V. Phone/Fax

Practice location:
  • Phone: 405-372-4482
  • Fax: 405-372-4490
Mailing address:
  • Phone: 405-372-4482
  • Fax: 405-372-4490

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2399
License Number StateOK

VIII. Authorized Official

Name: DR. KENNEY L. FIELD
Title or Position: PRESIDENT
Credential: DC
Phone: 405-372-4482