Provider Demographics
NPI:1326755125
Name:MINARD MOVEMENT CHIROPRACTIC
Entity Type:Organization
Organization Name:MINARD MOVEMENT CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MINARD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-883-6200
Mailing Address - Street 1:12110 ASHFORD DR STE 200
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-8759
Mailing Address - Country:US
Mailing Address - Phone:405-883-6200
Mailing Address - Fax:
Practice Address - Street 1:12110 ASHFORD DR STE 200
Practice Address - Street 2:
Practice Address - City:YUKON
Practice Address - State:OK
Practice Address - Zip Code:73099-8759
Practice Address - Country:US
Practice Address - Phone:405-883-6200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty