Provider Demographics
NPI:1346317278
Name:JAY CHIROPRACTIC HEALTH AND REHABILITATION LLC
Entity Type:Organization
Organization Name:JAY CHIROPRACTIC HEALTH AND REHABILITATION LLC
Other - Org Name:EAST WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC OWNER PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:EAST
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-253-3030
Mailing Address - Street 1:80 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-3403
Mailing Address - Country:US
Mailing Address - Phone:918-786-6700
Mailing Address - Fax:918-786-2846
Practice Address - Street 1:80 W. 7TH ST
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344
Practice Address - Country:US
Practice Address - Phone:918-786-6700
Practice Address - Fax:918-786-2846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty