Healthcare Provider Details

I. General information

NPI: 1265977615
Provider Name (Legal Business Name): TSAW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2016
Last Update Date: 08/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6949-51 E. 71ST ST.
TULSA OK
74145
US

IV. Provider business mailing address

6949-51 E. 71ST STREET
TULSA OK
74145
US

V. Phone/Fax

Practice location:
  • Phone: 918-808-8825
  • Fax:
Mailing address:
  • Phone: 918-808-7725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code364SF0001X
TaxonomyFamily Health Clinical Nurse Specialist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT THOMAS KIRKPATRICK
Title or Position: OWNER
Credential: D.C.
Phone: 918-808-7722