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General NPI Number Information
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NPI Number | 1437271558
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Entity Type | Individual
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Provider Name | JUSTIN LEE ASHLOCK D.C.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 09/22/2015
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Provider Practice Location Address
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Address Line | 12899 E. 76TH ST. N. STE. 101
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City | OWASSO
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State | OK
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Zip | 74055
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Country | US
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Telephone | 918-272-0444
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Fax | 918-272-0447
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Provider Business Mailing Address
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Address Line | 12899E 76TH N ST 101
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City | OWASSO
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State | OK
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Zip | 74055-4059
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Country | US
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Telephone | 918-272-0444
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 3807
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License Number State | OK
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