Provider Demographics
NPI:1548205933
Name:BAESE, GLORIA M (DC)
Entity Type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:M
Last Name:BAESE
Suffix:
Gender:F
Credentials:DC
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Mailing Address - Street 1:4608 S HARVARD AVE
Mailing Address - Street 2:STE C
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2913
Mailing Address - Country:US
Mailing Address - Phone:918-664-5588
Mailing Address - Fax:918-664-4394
Practice Address - Street 1:6913 S CANTON AVE
Practice Address - Street 2:300
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-3426
Practice Address - Country:US
Practice Address - Phone:918-664-5588
Practice Address - Fax:918-664-4394
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2017-01-25
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK2461111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor