Provider Demographics
NPI:1598944944
Name:SEUBOLD FAMILY CHIROPRACTIC INC
Entity Type:Organization
Organization Name:SEUBOLD FAMILY CHIROPRACTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:ARMBUSTER
Authorized Official - Last Name:SEUBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-427-3630
Mailing Address - Street 1:PO BOX 924
Mailing Address - Street 2:
Mailing Address - City:ROLAND
Mailing Address - State:OK
Mailing Address - Zip Code:74954-0924
Mailing Address - Country:US
Mailing Address - Phone:918-427-3630
Mailing Address - Fax:
Practice Address - Street 1:311 4 E RAY FINE BLVD
Practice Address - Street 2:SUITE4
Practice Address - City:ROLAND
Practice Address - State:OK
Practice Address - Zip Code:74954
Practice Address - Country:US
Practice Address - Phone:918-427-3630
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3745111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty