Provider Demographics
NPI:1235389735
Name:BARTLESVILLE CHIROPRACTIC, INC.
Entity Type:Organization
Organization Name:BARTLESVILLE CHIROPRACTIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:K
Authorized Official - Last Name:LEMAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-333-1515
Mailing Address - Street 1:1368 SE WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74006-4509
Mailing Address - Country:US
Mailing Address - Phone:918-333-1515
Mailing Address - Fax:918-331-9742
Practice Address - Street 1:1368 SE WASHINGTON BLVD STE B
Practice Address - Street 2:
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74006-4524
Practice Address - Country:US
Practice Address - Phone:918-333-1515
Practice Address - Fax:918-331-9742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3458111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK669386OtherA.C.N
OK7933090OtherAETNA
OK005700-22266OtherCUNNINGHAM LINDSEY INS CO
OKP00288613OtherMEDICARE RAILROAD
OK669386OtherA.C.N