Provider Demographics
NPI:1578813218
Name:EUBANKS, DEBRA ALEXANDRA (DC)
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:ALEXANDRA
Last Name:EUBANKS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2371
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73402-2371
Mailing Address - Country:US
Mailing Address - Phone:580-226-7181
Mailing Address - Fax:580-226-7192
Practice Address - Street 1:804 16TH AVE NW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1818
Practice Address - Country:US
Practice Address - Phone:580-226-7181
Practice Address - Fax:580-226-7192
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-10
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4084111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor