Provider Demographics
NPI:1376811091
Name:R A CHIROPRACTIC SERVICES INC
Entity Type:Organization
Organization Name:R A CHIROPRACTIC SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:DEAN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-234-2700
Mailing Address - Street 1:128 N OAKWOOD RD
Mailing Address - Street 2:
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-4946
Mailing Address - Country:US
Mailing Address - Phone:580-234-2700
Mailing Address - Fax:580-234-3338
Practice Address - Street 1:128 N OAKWOOD RD
Practice Address - Street 2:
Practice Address - City:ENID
Practice Address - State:OK
Practice Address - Zip Code:73703-4946
Practice Address - Country:US
Practice Address - Phone:580-234-2700
Practice Address - Fax:580-234-3338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-08
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3085111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty