Provider Demographics
NPI:1518464833
Name:FOCUS CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:FOCUS CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIRPRACTOR / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-767-9750
Mailing Address - Street 1:9101 S WESTERN AVE STE 112
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73139-2757
Mailing Address - Country:US
Mailing Address - Phone:735-274-4405
Mailing Address - Fax:405-767-9759
Practice Address - Street 1:9101 S WESTERN AVE STE 112
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2757
Practice Address - Country:US
Practice Address - Phone:735-274-4405
Practice Address - Fax:405-767-9759
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3256111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty