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NPI Code Detail

MEDICARE: THE CHIROPRACTIC CO. PLLC

MEDICARE: THE CHIROPRACTIC CO. PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor

General Provider Information

NPI Number : 1285332247
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE CHIROPRACTIC CO. PLLC
Provider Business Mailing Address
First Line : 1405 S MAIN ST
Second Line :
City : ELK CITY
State : OK
Zip : 73644-6913
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1405 S MAIN ST
Second Line :
City : ELK CITY
State : OK
Zip : 73644-6913
Country : US
Telephone Number : 580-339-8078
Fax Number :
Authorized Official
Title or Position : CO-OWNER/PRACTITIONER
Name : DR. MIKAYLA ROBERTSON
Credential : DC
Telephone Number : 580-821-1663
Provider Enumeration Date : 02/20/2023
Last Update Date : 02/20/2023

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Directions to “THE CHIROPRACTIC CO. PLLC ” Practice Location

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