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General NPI Number Information
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NPI Number | 1285332247
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Entity Type | Organization
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Legal Business Name | THE CHIROPRACTIC CO. PLLC
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Dates
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Enumeration Date | 02/20/2023
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Last Update Date | 02/20/2023
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Provider Practice Location Address
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Address Line | 1405 S MAIN ST
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City | ELK CITY
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State | OK
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Zip | 73644-6913
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Country | US
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Telephone | 580-339-8078
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Fax |
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Provider Business Mailing Address
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Address Line | 1405 S MAIN ST
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City | ELK CITY
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State | OK
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Zip | 73644-6913
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER/PRACTITIONER
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Name | DR. MIKAYLA ROBERTSON
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Credential | DC
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Telephone | 580-821-1663
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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 |
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License Number State |
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