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General NPI Number Information
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NPI Number | 1265638415
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Entity Type | Organization
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Legal Business Name | XAI CHIROPRACTIC AND ACUPUNCTURE
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Dates
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Enumeration Date | 06/25/2007
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 5436 S MINGO RD SUITE I
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City | TULSA
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State | OK
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Zip | 74146-5711
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Country | US
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Telephone | 918-622-3100
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Fax | 918-622-3103
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Provider Business Mailing Address
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Address Line | PO BOX 471543 SUITE I
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City | TULSA
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State | OK
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Zip | 74147-1543
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Country | US
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Telephone | 918-622-3100
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Fax | 918-622-3103
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Authorized Official
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Title or Position | OWNER
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Name | TINNAKON N XAIYARATT
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Credential | D.C.
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Telephone | 918-810-8416
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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 | 20070755
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License Number State | OK
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