Provider Demographics
NPI:1710029814
Name:CLINTON CHIROPRACTIC CENTER INC
Entity Type:Organization
Organization Name:CLINTON CHIROPRACTIC CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:L
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-323-4250
Mailing Address - Street 1:119 N 9TH ST
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:OK
Mailing Address - Zip Code:73601-3309
Mailing Address - Country:US
Mailing Address - Phone:580-323-4250
Mailing Address - Fax:580-323-4250
Practice Address - Street 1:119 N 9TH ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:OK
Practice Address - Zip Code:73601-3309
Practice Address - Country:US
Practice Address - Phone:580-323-4250
Practice Address - Fax:580-323-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1676111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty