MEDICARE: DOUG L PRAY D.C.

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	3345	OK

General Provider Information

NPI Number	:	1699846949
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUG L PRAY D.C.

Provider Business Mailing Address
First Line	:	1825 E 15TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-4610
Country	:	US
Telephone Number	:	918-712-2220
Fax Number	:	918-712-7379

Provider Business Practice Location Address
First Line	:	1825 E 15TH ST
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-4610
Country	:	US
Telephone Number	:	918-712-2220
Fax Number	:	918-712-7379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2006
Last Update Date	:	07/08/2007

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Directions to “ DOUG L PRAY D.C.” Practice Location

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