Provider Demographics
NPI:1134474463
Name:WILBANKS, KENDRA R (DC)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:R
Last Name:WILBANKS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:R
Other - Last Name:LEGGETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:7877 S SHERIDAN RD
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-3456
Mailing Address - Country:US
Mailing Address - Phone:918-492-1618
Mailing Address - Fax:918-492-1813
Practice Address - Street 1:7877 S SHERIDAN RD
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-3456
Practice Address - Country:US
Practice Address - Phone:918-492-1618
Practice Address - Fax:918-492-1813
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4060111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor