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General NPI Number Information
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NPI Number | 1003773664
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Entity Type | Individual
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Provider Name | CHRIS C MCCORMICK
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Gender | Male
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Dates
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Enumeration Date | 01/06/2026
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 12205 S WESTERN AVE APT 1234
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City | OKLAHOMA CITY
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State | OK
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Zip | 73170-5970
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Country | US
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Telephone | 405-367-3887
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Fax |
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Provider Business Mailing Address
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Address Line | 3910 SE 12TH ST
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City | DEL CITY
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State | OK
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Zip | 73115-2218
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Country | US
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Telephone | 405-367-3887
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 207897
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License Number State | OK
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