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General NPI Number Information
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NPI Number | 1972740264
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Entity Type | Organization
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Legal Business Name | HEALING LIFE CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 1335 E 11TH ST SUITE A
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City | TULSA
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State | OK
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Zip | 74120-4602
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Country | US
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Telephone | 918-500-4452
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Fax |
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Provider Business Mailing Address
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Address Line | 1335 E 11TH ST SUITE A
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City | TULSA
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State | OK
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Zip | 74120-4602
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Country | US
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Telephone | 918-500-4452
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. SHANNON GULBRANSON
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Credential | D.C.
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Telephone | 918-500-4452
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 3737
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License Number State | OK
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