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General NPI Number Information
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NPI Number | 1568836914
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Entity Type | Organization
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Legal Business Name | JOHN TERRY GODFREY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 11/23/2015
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 400 S BROADWAY
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City | EDMOND
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State | OK
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Zip | 73034-3848
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Country | US
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Telephone | 405-345-5963
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Fax | 405-393-9918
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Provider Business Mailing Address
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Address Line | 400 S BROADWAY
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City | EDMOND
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State | OK
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Zip | 73034-3848
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Country | US
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Telephone | 405-345-5963
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Fax | 405-393-9918
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. JOHN TERRY GODFREY
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Credential | DC
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Telephone | 405-345-5963
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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 | 2437
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License Number State | OK
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