MEDICARE: FEATHERSTON 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	4175	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1821467036	OTHER		GROUP
2	1962809384	OTHER		INDIVIDUAL NPI

General Provider Information

NPI Number	:	1821467036
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FEATHERSTON CHIROPRACTIC LLC

Provider Business Mailing Address
First Line	:	3315 E 47TH PL STE 120
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-2914
Country	:	US
Telephone Number	:	918-622-9655
Fax Number	:	918-622-9657

Provider Business Practice Location Address
First Line	:	3315 E 47TH PL STE 120
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74135-2914
Country	:	US
Telephone Number	:	918-622-9655
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. CHES FEATHERSTON IV
Credential	:	DC
Telephone Number	:	913-951-9419

Provider Enumeration Date	:	09/17/2015
Last Update Date	:	12/07/2015

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Directions to “FEATHERSTON CHIROPRACTIC LLC ” Practice Location

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