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General NPI Number Information
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NPI Number | 1669650412
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Entity Type | Individual
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Provider Name | BEVERLY LAROSA GLINSKY D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/04/2008
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Last Update Date | 06/17/2010
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Provider Practice Location Address
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Address Line | 1712 S POST RD STE B
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City | MIDWEST CITY
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State | OK
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Zip | 73130-6613
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Country | US
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Telephone | 405-455-7555
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Fax | 405-455-7556
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Provider Business Mailing Address
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Address Line | 1712 S POST RD STE B
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City | MIDWEST CITY
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State | OK
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Zip | 73130-6613
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Country | US
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Telephone | 405-455-7555
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 3868
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License Number State | OK
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