Provider Demographics
NPI:1770847956
Name:PRECISION CARE CHIROPRACTIC, PLLC
Entity Type:Organization
Organization Name:PRECISION CARE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:N
Authorized Official - Last Name:BAMPOE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-803-8770
Mailing Address - Street 1:5850 W WILSHIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-4904
Mailing Address - Country:US
Mailing Address - Phone:405-803-8770
Mailing Address - Fax:405-338-1622
Practice Address - Street 1:5850 W WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-4904
Practice Address - Country:US
Practice Address - Phone:405-803-8770
Practice Address - Fax:405-338-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200547200AMedicaid