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General NPI Number Information
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NPI Number | 1437519428
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Entity Type | Organization
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Legal Business Name | ADVANCED CHIROPRACTIC & HEALTH
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Dates
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Enumeration Date | 03/03/2016
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Last Update Date | 02/07/2024
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Provider Practice Location Address
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Address Line | 7919 MID AMERICA BLVD
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City | OKLAHOMA CITY
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State | OK
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Zip | 73135-6610
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Country | US
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Telephone | 405-855-6000
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 608
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City | COWETA
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State | OK
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Zip | 74429
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Country | US
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Telephone | 918-486-1490
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Fax | 918-486-1595
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Authorized Official
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Title or Position | PHYSICIAN
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Name | MR. CURTIS WAYNE TILLMAN
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Credential | D.C., D.A.C.N.B.
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Telephone | 918-486-1490
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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 | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 3869
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License Number State | OK
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Taxonomy #4
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 3869
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License Number State | OK
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