Provider Demographics
NPI:1427204361
Name:CHICOINE CHIROPRACTIC CLINIC INC
Entity Type:Organization
Organization Name:CHICOINE CHIROPRACTIC CLINIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:CHICOINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-836-2225
Mailing Address - Street 1:3739 E 11TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-3951
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:74112-3951
Practice Address - Country:US
Practice Address - Phone:918-836-2225
Practice Address - Fax:918-834-3174
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center