MEDICARE: HELIX INTEGRATED HEALTH

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	111NS0005X	Sports Physician Chiropractor	4156	OK

General Provider Information

NPI Number	:	1609321223
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HELIX INTEGRATED HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 20328
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73156-0328
Country	:	US
Telephone Number	:	405-537-5665
Fax Number	:

Provider Business Practice Location Address
First Line	:	9402 N MAY AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73120-2701
Country	:	US
Telephone Number	:	405-537-5665
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ROY HANSEN
Credential	:	D.C.
Telephone Number	:	405-537-5665

Provider Enumeration Date	:	08/24/2016
Last Update Date	:	08/24/2016

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Directions to “HELIX INTEGRATED HEALTH ” Practice Location

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