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General NPI Number Information
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NPI Number | 1831492305
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Entity Type | Organization
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Legal Business Name | HEALTH AND STABILITY SPINAL CARE
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Dates
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Enumeration Date | 12/06/2010
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Last Update Date | 12/06/2010
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Provider Practice Location Address
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Address Line | 10020 S MINGO RD STE A
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City | TULSA
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State | OK
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Zip | 74133-5706
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Country | US
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Telephone | 918-991-5427
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Fax |
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Provider Business Mailing Address
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Address Line | 7122 S SHERIDAN RD SUITE 2-174
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City | TULSA
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State | OK
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Zip | 74133-2748
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. CHRISTINE NICOLE BAGNARO
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Credential | D.C.
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Telephone | 918-991-5427
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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 | 3933
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License Number State | OK
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