Provider Demographics
NPI:1346536901
Name:LEPIEN WELLNESS CLINIC, LLC
Entity Type:Organization
Organization Name:LEPIEN WELLNESS CLINIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEPIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-658-1042
Mailing Address - Street 1:1202 S BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MARLOW
Mailing Address - State:OK
Mailing Address - Zip Code:73055-3864
Mailing Address - Country:US
Mailing Address - Phone:580-658-1042
Mailing Address - Fax:580-658-1042
Practice Address - Street 1:1202 S BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MARLOW
Practice Address - State:OK
Practice Address - Zip Code:73055-3864
Practice Address - Country:US
Practice Address - Phone:580-658-1042
Practice Address - Fax:580-658-1042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-22
Last Update Date:2012-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4005111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty