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General NPI Number Information
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NPI Number | 1801964762
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Entity Type | Individual
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Provider Name | MARY GALE BERGHAUS DC
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Gender | Female
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 06/13/2025
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Provider Practice Location Address
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Address Line | 7023 E 100TH PL
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City | TULSA
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State | OK
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Zip | 74133-6202
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Country | US
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Telephone | 918-698-0833
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Fax | 918-298-1077
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Provider Business Mailing Address
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Address Line | 7023 E 100TH PL
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City | TULSA
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State | OK
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Zip | 74133-6202
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Country | US
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Telephone | 918-698-0833
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Fax | 918-298-1077
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | OK3292
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License Number State | OK
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