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General NPI Number Information
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NPI Number | 1366987216
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Entity Type | Organization
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Legal Business Name | CHARLES DYE DC PLLC
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Dates
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Enumeration Date | 01/02/2017
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Last Update Date | 04/10/2019
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Provider Practice Location Address
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Address Line | 202 W. BLUE STARR DRIVE
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City | CLAREMORE
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State | OK
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Zip | 74017-4228
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Country | US
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Telephone | 918-342-3737
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Fax | 918-342-3751
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Provider Business Mailing Address
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Address Line | PO BOX 1827
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City | CLAREMORE
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State | OK
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Zip | 74018-1827
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Country | US
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Telephone | 918-636-2244
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Fax | 918-342-3751
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Authorized Official
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Title or Position | SINGLE MEMBER
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Name | DR. CHARLES H. DYE
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Credential | D.C.
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Telephone | 918-342-3737
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 2205
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License Number State | OK
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