Provider Demographics
NPI:1417538893
Name:PAULS VALLEY CHIROPRACTIC
Entity Type:Organization
Organization Name:PAULS VALLEY CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:PERKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-926-2033
Mailing Address - Street 1:PO BOX 1280
Mailing Address - Street 2:
Mailing Address - City:PAULS VALLEY
Mailing Address - State:OK
Mailing Address - Zip Code:73075-2080
Mailing Address - Country:US
Mailing Address - Phone:405-926-2033
Mailing Address - Fax:405-926-2034
Practice Address - Street 1:400 S WALNUT ST
Practice Address - Street 2:
Practice Address - City:PAULS VALLEY
Practice Address - State:OK
Practice Address - Zip Code:73075-3811
Practice Address - Country:US
Practice Address - Phone:405-926-2033
Practice Address - Fax:405-926-2034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-18
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty