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General NPI Number Information
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NPI Number | 1073706024
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Entity Type | Organization
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Legal Business Name | MCGOWAN CHIROPARACTIC CLINIC, INC.
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Dates
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Enumeration Date | 08/23/2007
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Last Update Date | 06/21/2018
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Provider Practice Location Address
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Address Line | 102 W RANDOLPH AVE
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City | ENID
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State | OK
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Zip | 73701-4005
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Country | US
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Telephone | 580-233-4300
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Fax | 580-233-0769
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Provider Business Mailing Address
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Address Line | 102 W RANDOLPH AVE
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City | ENID
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State | OK
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Zip | 73701-4005
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Country | US
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Telephone | 580-233-4300
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Fax | 580-233-0769
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Authorized Official
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Title or Position | DR
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Name | DR. FRANK KAMPSCHROEDER
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Credential |
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Telephone | 580-233-4300
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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 | 2628
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License Number State | OK
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