MEDICARE: LIMITLESS CHIROPRACTIC LLC

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
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1457032625
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMITLESS CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	220 SW 167TH TER
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73170-6717
Country	:	US
Telephone Number	:	405-637-8803
Fax Number	:

Provider Business Practice Location Address
First Line	:	220 SW 167TH TER
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73170-6717
Country	:	US
Telephone Number	:	405-637-8803
Fax Number	:

Authorized Official
Title or Position	:	OWNER,/OPERATOR
Name	:	JORDAN MICHAEL LOGSDON
Credential	:	DC
Telephone Number	:	405-637-8803

Provider Enumeration Date	:	07/28/2023
Last Update Date	:	08/02/2023

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