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General NPI Number Information
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NPI Number | 1154683423
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Entity Type | Organization
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Legal Business Name | PRINCE CHIROPRACTIC WELLNESS CENTER, PLLC
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Dates
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Enumeration Date | 06/13/2012
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Last Update Date | 02/23/2023
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Provider Practice Location Address
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Address Line | 13501 N EASTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73131-1824
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Country | US
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Telephone | 405-757-2079
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Fax | 405-493-0713
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Provider Business Mailing Address
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Address Line | 13501 N EASTERN AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73131-1824
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Country | US
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Telephone | 405-757-2079
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Fax | 405-493-0713
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Authorized Official
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Title or Position | OWNER
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Name | DANIEL PRINCE
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Credential | D.C.
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Telephone | 405-757-2079
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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 | 4051
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License Number State | OK
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