Healthcare Provider Details

I. General information

NPI: 1962362103
Provider Name (Legal Business Name): FULL ARMOR CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 01/16/2026
Certification Date: 01/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5666 S 122ND E AVE, UNIT A-11
TULSA OK
74146
US

IV. Provider business mailing address

16704 E 43RD STREET S
TULSA OK
74134
US

V. Phone/Fax

Practice location:
  • Phone: 918-992-4592
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DYLAN CRIQUET DANIELSON
Title or Position: OWNER
Credential: DC
Phone: 507-828-2575