Provider Demographics
NPI:1376655860
Name:CHICOINE, GERALD D (DC)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:D
Last Name:CHICOINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3739 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112
Mailing Address - Country:US
Mailing Address - Phone:918-836-2225
Mailing Address - Fax:918-834-3174
Practice Address - Street 1:3739 E 11TH ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74112
Practice Address - Country:US
Practice Address - Phone:918-836-2225
Practice Address - Fax:918-834-3174
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3107111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor