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General NPI Number Information
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NPI Number | 1164616512
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Entity Type | Organization
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Legal Business Name | CHOICE CHIROPRACTIC & ACUPUNCTURE, P.L.L.C.
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Dates
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Enumeration Date | 08/29/2007
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Last Update Date | 08/29/2007
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Provider Practice Location Address
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Address Line | 8805 N 145TH EAST AVE STE. 103
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City | OWASSO
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State | OK
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Zip | 74055-8529
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Country | US
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Telephone | 918-274-9299
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Fax | 918-274-9220
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Provider Business Mailing Address
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Address Line | 8805 N 145TH EAST AVE STE. 103
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City | OWASSO
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State | OK
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Zip | 74055-8529
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Country | US
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Telephone | 918-274-9299
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Fax | 918-274-9220
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Authorized Official
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Title or Position | OWNER
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Name | DR. HEATHER VAN WYHE
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Credential |
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Telephone | 918-274-9299
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State |
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Taxonomy #2
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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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