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NPI Code Detail

MEDICARE: HAI TIEN D.C

MEDICARE: HAI TIEN 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
1111NR0400XRehabilitation Chiropractor3440OK

General Provider Information

NPI Number : 1740466317
Entity Type Code : Individual
Provider Name (Legal Business Name) : HAI TIEN D.C
Provider Business Mailing Address
First Line : 4609 N CLASSEN BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-4815
Country : US
Telephone Number : 405-840-1117
Fax Number : 405-840-0442
Provider Business Practice Location Address
First Line : 4609 N CLASSEN BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-4815
Country : US
Telephone Number : 405-840-1117
Fax Number : 405-840-0442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2008
Last Update Date : 01/14/2008

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Directions to “ HAI TIEN D.C” Practice Location

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