MEDICARE: JAKE WESLEY LANDRETH DC

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	4002	OK

General Provider Information

NPI Number	:	1902106768
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAKE WESLEY LANDRETH DC

Provider Business Mailing Address
First Line	:	12707 E 86TH ST N
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-2506
Country	:	US
Telephone Number	:	918-272-7432
Fax Number	:	918-272-7448

Provider Business Practice Location Address
First Line	:	12707 E 86TH ST N
Second Line	:
City	:	OWASSO
State	:	OK
Zip	:	74055-2506
Country	:	US
Telephone Number	:	918-272-7432
Fax Number	:	918-272-7448

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

Provider Enumeration Date	:	10/27/2010
Last Update Date	:	10/27/2010

Similar Medicare Providers

1033271655 — STANDRIDGE CLINIC INC
Practice Location Address:

12707 E 86TH ST N
OWASSO, OK
74055-2506

Practice Phone: 918-272-7432
Practice Fax: 918-272-7448

1093293573 — OWASSO PAIN MANAGEMENT
Practice Location Address:

12707 E 86TH ST N
OWASSO, OK
74055-2506

Practice Phone: 918-272-7432
Practice Fax: 918-272-7448

1295687770 — TRICIA NICOLE GRONDIN RN
Practice Location Address:

12017 E 109TH ST N
OWASSO, OK
74055-7466

Practice Phone: 626-377-0617
Practice Fax:

1700333416 — MISS KIMBERLY RENEE MARTIN BCBA-D
Practice Location Address:

108 W 1ST AVE STE C
OWASSO, OK
74055-3137

Practice Phone: 855-223-7123
Practice Fax:

1790637841 — KENNEDY GUEST
Practice Location Address:

11412 N 134TH EAST AVE STE C3
OWASSO, OK
74055-4969

Practice Phone: 918-376-3087
Practice Fax:

1376495911 — JACILYN BURNS
Practice Location Address:

11412 N 134TH EAST AVE STE C3
OWASSO, OK
74055-4969

Practice Phone: 918-376-3087
Practice Fax:

Directions to “ JAKE WESLEY LANDRETH DC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.