Provider Demographics
NPI:1679634489
Name:GUADAGNO, ANTHONY VINCENT (DC)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:VINCENT
Last Name:GUADAGNO
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 1:5115 NW 16
Mailing Address - Street 2:
Mailing Address - City:OKLA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73127-2807
Mailing Address - Country:US
Mailing Address - Phone:405-949-1194
Mailing Address - Fax:
Practice Address - Street 1:5115 NW 16
Practice Address - Street 2:
Practice Address - City:OKLA CITY
Practice Address - State:OK
Practice Address - Zip Code:73127-2807
Practice Address - Country:US
Practice Address - Phone:405-949-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1178111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor