Provider Demographics
NPI:1043761422
Name:NORTH OKC CHIROPRACTIC
Entity Type:Organization
Organization Name:NORTH OKC CHIROPRACTIC
Other - Org Name:ENGLEWOOD CHIROPRACTIC LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ATKINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-810-5501
Mailing Address - Street 1:5109 N SHARTEL AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73118-6024
Mailing Address - Country:US
Mailing Address - Phone:405-810-5501
Mailing Address - Fax:888-481-4758
Practice Address - Street 1:5109 N SHARTEL AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73118-6024
Practice Address - Country:US
Practice Address - Phone:405-810-5501
Practice Address - Fax:888-481-4758
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4237111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty