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General NPI Number Information
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NPI Number | 1508016098
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Entity Type | Organization
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Legal Business Name | SHENLOOGIAN CHIROPRACTIC & ACUPUNCTURE CLINIC, LLC
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 09/22/2008
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Provider Practice Location Address
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Address Line | 4146 S HARVARD AVE SUITE F-2
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City | TULSA
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State | OK
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Zip | 74135-2610
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Country | US
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Telephone | 918-933-5445
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Fax | 918-933-5446
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Provider Business Mailing Address
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Address Line | 4146 S HARVARD AVE SUITE F-2
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City | TULSA
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State | OK
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Zip | 74135-2610
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Country | US
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Telephone | 918-933-5445
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Fax | 918-933-5446
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. JASON SHENLOOGIAN
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Credential | D.C.
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Telephone | 918-645-0838
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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 | 3901
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License Number State | OK
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