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General NPI Number Information
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NPI Number | 1871535336
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Entity Type | Organization
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Legal Business Name | VALCASARA CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/11/2006
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Last Update Date | 04/13/2009
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Provider Practice Location Address
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Address Line | 800 N. COMMERCE ST
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City | ARDMORE
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State | OK
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Zip | 73401-3917
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Country | US
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Telephone | 580-226-3388
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Fax | 580-226-7296
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Provider Business Mailing Address
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Address Line | 800 N. COMMERCE ST
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City | ARDMORE
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State | OK
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Zip | 73401-3917
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Country | US
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Telephone | 580-226-3388
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Fax | 580-226-7296
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. JODIE MICHELLE MORRIS-VALCASARA
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Credential | D.C.
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Telephone | 580-226-3388
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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 | 3410
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License Number State | OK
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