Provider Demographics
NPI:1184819294
Name:LAMBORN CLINIC OF CHIROPRACTIC & ACUPUNCTURE, P.C.
Entity Type:Organization
Organization Name:LAMBORN CLINIC OF CHIROPRACTIC & ACUPUNCTURE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCK
Authorized Official - Middle Name:OLIVER
Authorized Official - Last Name:LAMBORN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-492-9111
Mailing Address - Street 1:6947 S LEWIS AVE
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3914
Mailing Address - Country:US
Mailing Address - Phone:918-492-9111
Mailing Address - Fax:918-492-5284
Practice Address - Street 1:6947 S LEWIS AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3914
Practice Address - Country:US
Practice Address - Phone:918-492-9111
Practice Address - Fax:918-492-5284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-11
Last Update Date:2007-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU72309Medicare UPIN