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General NPI Number Information
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NPI Number | 1942087341
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Entity Type | Organization
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Legal Business Name | CLAREMORE CHIROPRACTIC AND REHAB INC.
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 900 E WILL ROGERS BLVD STE D
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City | CLAREMORE
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State | OK
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Zip | 74017-6307
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Country | US
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Telephone | 918-341-6535
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Fax | 918-341-6566
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Provider Business Mailing Address
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Address Line | 9236 N 144TH EAST AVE
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City | OWASSO
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State | OK
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Zip | 74055-2681
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Country | US
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Telephone | 918-884-9418
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Fax |
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Authorized Official
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Title or Position | ASSOCIATE CHIROPRACTOR
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Name | DR. DRAKE GARDNER
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Credential | DC
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Telephone | 918-884-9418
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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 |
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License Number State |
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