Provider Demographics
NPI:1699176107
Name:ADAMS, MICHELLE LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:LYNN
Last Name:ADAMS
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 1:2945 NW EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-6239
Mailing Address - Country:US
Mailing Address - Phone:580-695-5273
Mailing Address - Fax:580-209-4670
Practice Address - Street 1:1711 W GORE BLVD STE C
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3638
Practice Address - Country:US
Practice Address - Phone:580-695-5273
Practice Address - Fax:580-209-4670
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-16
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4169111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU25174Medicaid