Provider Demographics
NPI:1649395716
Name:MEIER, MICHAEL DALE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:DALE
Last Name:MEIER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 COLLEGE BLVD
Mailing Address - Street 2:
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-3414
Mailing Address - Country:US
Mailing Address - Phone:580-327-2468
Mailing Address - Fax:580-327-3403
Practice Address - Street 1:1716 COLLEGE BLVD
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-3414
Practice Address - Country:US
Practice Address - Phone:580-327-2468
Practice Address - Fax:580-327-3403
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2210111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK731111089-001OtherBLUE CROSS BLUE SHIELD
OKQDCJRMedicare PIN