Provider Demographics
NPI:1073706024
Name:MCGOWAN CHIROPARACTIC CLINIC, INC.
Entity Type:Organization
Organization Name:MCGOWAN CHIROPARACTIC CLINIC, INC.
Other - Org Name:THE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DR
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMPSCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-233-4300
Mailing Address - Street 1:102 W RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73701-4005
Mailing Address - Country:US
Mailing Address - Phone:580-233-4300
Mailing Address - Fax:580-233-0769
Practice Address - Street 1:102 W RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73701-4005
Practice Address - Country:US
Practice Address - Phone:580-233-4300
Practice Address - Fax:580-233-0769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-23
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2628111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========OtherTAX ID#