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General NPI Number Information
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NPI Number | 1356569784
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Entity Type | Organization
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Legal Business Name | SPINAL WELLNESS CLINIC, P.C.
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 01/13/2015
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Provider Practice Location Address
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Address Line | 14901 N. KELLY AVE STE 101
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City | OKC
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-607-6222
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Fax | 405-607-6232
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Provider Business Mailing Address
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Address Line | 14901 N. KELLY AVE STE 101
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City | OKC
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State | OK
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Zip | 73013
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Country | US
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Telephone | 405-607-6222
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Fax | 405-607-6232
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Authorized Official
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Title or Position | OWNER
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Name | ASHLEIGH ROCHELLE MUSE
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Credential | D.C.
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Telephone | 405-607-6222
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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 | 3391
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License Number State | OK
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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 | 3379
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License Number State | OK
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