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General NPI Number Information
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NPI Number | 1073868089
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Entity Type | Organization
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Legal Business Name | HINDS FAMILY CHIROPRACTIC PC
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Dates
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Enumeration Date | 07/16/2012
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Last Update Date | 05/30/2013
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Provider Practice Location Address
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Address Line | 222 E BLUE STARR DR
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City | CLAREMORE
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State | OK
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Zip | 74017-4223
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Country | US
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Telephone | 918-342-3444
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Fax | 918-342-3445
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Provider Business Mailing Address
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Address Line | 222 E. BLUE STARR DR
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City | CLAREMORE
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State | OK
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Zip | 74017
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Country | US
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Telephone | 918-342-3444
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Fax | 918-342-3445
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MICHAEL JORDAN HINDS
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Credential | DC
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Telephone | 918-342-3444
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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 | 4068
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License Number State | OK
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