Provider Demographics
NPI:1265651491
Name:MANIPULATION & SPECIALTY HEALTHCARE, INC
Entity Type:Organization
Organization Name:MANIPULATION & SPECIALTY HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:GILBERT
Authorized Official - Last Name:HONEYCUTT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:918-779-5907
Mailing Address - Street 1:13809 S CASPER ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:GLENPOOL
Mailing Address - State:OK
Mailing Address - Zip Code:74033-2618
Mailing Address - Country:US
Mailing Address - Phone:918-291-0189
Mailing Address - Fax:918-291-0190
Practice Address - Street 1:13809 S CASPER ST
Practice Address - Street 2:SUITE D
Practice Address - City:GLENPOOL
Practice Address - State:OK
Practice Address - Zip Code:74033-2618
Practice Address - Country:US
Practice Address - Phone:918-291-0189
Practice Address - Fax:918-291-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3069204D00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
No204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK2000313580AMedicaid
OK2000313580AMedicaid