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General NPI Number Information
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NPI Number | 1346695491
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Entity Type | Organization
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Legal Business Name | LAWTON CHIROPRACTIC, PLLC
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Dates
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Enumeration Date | 04/26/2016
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Last Update Date | 05/04/2017
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Provider Practice Location Address
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Address Line | 1818 W GORE BLVD
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City | LAWTON
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State | OK
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Zip | 73501-3615
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Country | US
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Telephone | 580-699-5115
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3165
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City | LAWTON
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State | OK
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Zip | 73502-3165
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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 | CHIROPRACTOR
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Name | DR. CARI GUIDRY
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Credential |
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Telephone | 580-699-5115
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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 | 4205, 4208
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License Number State | OK
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