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General NPI Number Information
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NPI Number | 1992561757
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Entity Type | Organization
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Legal Business Name | CHIROPRACTIC NEUROLOGY SERVICES, PLLC
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Dates
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Enumeration Date | 02/27/2024
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Last Update Date | 02/27/2024
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Provider Practice Location Address
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Address Line | 3120 W BRITTON RD STE 201
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-2038
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Country | US
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Telephone | 239-896-0974
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 20173
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City | OKLAHOMA CITY
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State | OK
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Zip | 73156-0173
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Country | US
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Telephone | 239-896-0974
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Fax |
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | DR. ANTHONY INGLESE
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Credential | DC
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Telephone | 239-896-0974
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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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