Provider Demographics
NPI:1689337503
Name:LEDOUX, SEBASTIEN (DC)
Entity Type:Individual
Prefix:DR
First Name:SEBASTIEN
Middle Name:
Last Name:LEDOUX
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 1:1318 E 41ST ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-4032
Mailing Address - Country:US
Mailing Address - Phone:918-743-7923
Mailing Address - Fax:
Practice Address - Street 1:1318 E 41ST ST
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-4032
Practice Address - Country:US
Practice Address - Phone:918-743-7923
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-18
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4450111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor