MEDICARE: RAPHA HEALTH INSTITUTE

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	3602	OK

General Provider Information

NPI Number	:	1649575150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAPHA HEALTH INSTITUTE

Provider Business Mailing Address
First Line	:	7349 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2007
Country	:	US
Telephone Number	:	405-684-8979
Fax Number	:

Provider Business Practice Location Address
First Line	:	7349 S WESTERN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73139-2007
Country	:	US
Telephone Number	:	405-684-8979
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. MONTY HARRIS
Credential	:	D,C.
Telephone Number	:	405-684-8979

Provider Enumeration Date	:	01/13/2011
Last Update Date	:	01/13/2011

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