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General NPI Number Information
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NPI Number | 1093860272
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Entity Type | Organization
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Legal Business Name | STILLWATER CHIROPRACTIC CLINIC INC
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 211 N PERKINS RD STE 20
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City | STILLWATER
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State | OK
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Zip | 74075-5518
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Country | US
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Telephone | 405-372-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 211 N PERKINS RD STE 20
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City | STILLWATER
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State | OK
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Zip | 74075-5518
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Country | US
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Telephone | 405-372-2400
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. EDWARD E ECHALK
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Credential | D.C.
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Telephone | 405-372-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number | 2624
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License Number State | OK
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