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NPI Code Detail

MEDICARE: ODUM CHIROPRACTIC CLINIC PLLC

MEDICARE: ODUM CHIROPRACTIC CLINIC 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 : 1346349255
Entity Type Code : Organization
Provider Name (Legal Business Name) : ODUM CHIROPRACTIC CLINIC PLLC
Provider Business Mailing Address
First Line : 1004 NW 150TH
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73013
Country : US
Telephone Number : 405-286-9977
Fax Number : 405-286-9979
Provider Business Practice Location Address
First Line : 1004 NW 150TH
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73013-0000
Country : US
Telephone Number : 405-286-9977
Fax Number : 405-286-9979
Authorized Official
Title or Position : DR. BRETT ODUM PLLC
Name : DR. BRETT ODUM
Credential : PLLC
Telephone Number : 405-286-9977
Provider Enumeration Date : 09/21/2006
Last Update Date : 08/22/2020

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Directions to “ODUM CHIROPRACTIC CLINIC PLLC ” Practice Location

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