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General NPI Number Information
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NPI Number | 1740552082
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Entity Type | Organization
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Legal Business Name | REGIONAL CHIROPRACTIC HEALTH CENTER OF MCALESTER, PLLC
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Dates
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Enumeration Date | 02/02/2012
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 1103 N STRONG BLVD
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City | MCALESTER
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State | OK
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Zip | 74501-4263
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Country | US
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Telephone | 918-423-2526
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Fax | 918-423-2527
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Provider Business Mailing Address
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Address Line | 1103 N STRONG BLVD
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City | MCALESTER
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State | OK
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Zip | 74501-4263
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Country | US
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Telephone | 918-423-2526
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Fax | 918-423-2527
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Authorized Official
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Title or Position | BUSINESS MANAGER
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Name | MRS. DEANNA POWELL
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Credential |
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Telephone | 918-423-2526
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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 | 3204
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License Number State | OK
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