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General NPI Number Information
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NPI Number | 1073314688
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Entity Type | Organization
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Legal Business Name | REFORM CHIROPRACTIC & WELLNESS HUB
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Dates
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Enumeration Date | 03/20/2025
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 712 WEST MAIN STREET
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City | JENKS
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State | OK
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Zip | 74037-3519
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Country | US
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Telephone | 918-528-5880
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Fax | 918-880-3080
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Provider Business Mailing Address
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Address Line | 712 WEST MAIN STREET
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City | JENKS
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State | OK
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Zip | 74037-3519
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Country | US
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Telephone | 918-528-5880
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Fax | 918-880-3080
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. JOHN OWENS
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Credential | DC
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Telephone | 918-528-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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