Healthcare Provider Details

I. General information

NPI: 1902020449
Provider Name (Legal Business Name): REESE CHIROPRACTIC AND WELLNESS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2007
Last Update Date: 08/26/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1505 S SANGRE RD
STILLWATER OK
74074
US

IV. Provider business mailing address

1505 S SANGRE RD
STILLWATER OK
74074
US

V. Phone/Fax

Practice location:
  • Phone: 405-372-9200
  • Fax: 405-372-9203
Mailing address:
  • Phone: 405-372-9200
  • Fax: 405-372-9203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3614
License Number StateOK

VIII. Authorized Official

Name: J WESTON HEATH REESE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 405-372-9200