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General NPI Number Information
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NPI Number | 1386024248
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Entity Type | Organization
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Legal Business Name | ADVANCED RELIEF CHIROPRACTIC
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Dates
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Enumeration Date | 06/05/2015
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Last Update Date | 06/05/2015
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Provider Practice Location Address
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Address Line | 8020-B N. MAY AVE.
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120
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Country | US
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Telephone | 405-822-4476
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Fax |
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Provider Business Mailing Address
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Address Line | 2408 SE 92ND TER
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City | MOORE
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State | OK
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Zip | 73160-6098
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Country | US
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Telephone | 904-955-7237
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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. ELLICIA CLAIRE KAISER
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Credential |
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Telephone | 904-955-7237
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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 | 4191
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License Number State | OK
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