Provider Demographics
NPI:1073868089
Name:HINDS FAMILY CHIROPRACTIC PC
Entity Type:Organization
Organization Name:HINDS FAMILY CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JORDAN
Authorized Official - Last Name:HINDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-342-3444
Mailing Address - Street 1:222 E. BLUE STARR DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMORE
Mailing Address - State:OK
Mailing Address - Zip Code:74017
Mailing Address - Country:US
Mailing Address - Phone:918-342-3444
Mailing Address - Fax:918-342-3445
Practice Address - Street 1:222 E BLUE STARR DR
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-4223
Practice Address - Country:US
Practice Address - Phone:918-342-3444
Practice Address - Fax:918-342-3445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-16
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4068111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty