Healthcare Provider Details

I. General information

NPI: 1861431918
Provider Name (Legal Business Name): KENNEY L. FIELD JR. CHIROPRACTOR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 08/13/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 W UNIVERSITY AVE
STILLWATER OK
74074-3034
US

IV. Provider business mailing address

615 W UNIVERSITY AVE
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:
Title or Position:
Credential:
Phone: