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General NPI Number Information
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NPI Number | 1528364205
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Entity Type | Organization
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Legal Business Name | INTEGRATED PHYSICAL HEALTH LLC
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Dates
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Enumeration Date | 01/28/2011
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Last Update Date | 08/25/2020
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Provider Practice Location Address
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Address Line | 4564 S HARVARD AVE SUITE B
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City | TULSA
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State | OK
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Zip | 74135-2918
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Country | US
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Telephone | 918-231-7832
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Fax |
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Provider Business Mailing Address
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Address Line | 4564 S HARVARD AVE SUITE B
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City | TULSA
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State | OK
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Zip | 74135-2918
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TYLER BACHMAN
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Credential | D.C.
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Telephone | 918-231-7832
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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 | 3877
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License Number State | OK
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