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General NPI Number Information
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NPI Number | 1558727701
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Entity Type | Organization
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Legal Business Name | NICHOLS CHIROPRACTIC, LLC
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Dates
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Enumeration Date | 01/04/2016
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Last Update Date | 09/26/2024
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Provider Practice Location Address
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Address Line | 11462 S UNION AVE STE A
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City | JENKS
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State | OK
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Zip | 74037-6902
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Country | US
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Telephone | 918-512-8186
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Fax |
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Provider Business Mailing Address
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Address Line | 11462 S UNION AVE STE A
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City | JENKS
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State | OK
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Zip | 74037-6902
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Country | US
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Telephone | 918-512-8186
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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. KASEY MICHELLE NICHOLS
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Credential | D.C.
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Telephone | 918-637-3630
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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 | 3981
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License Number State | OK
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