Provider Demographics
NPI:1821274911
Name:GE CARPENTER PC
Entity Type:Organization
Organization Name:GE CARPENTER PC
Other - Org Name:CARPENTER CHIROPRACTIC CLINIC PC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:G
Authorized Official - Middle Name:E
Authorized Official - Last Name:CARPENTER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-769-6767
Mailing Address - Street 1:9820 NE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73141-4208
Mailing Address - Country:US
Mailing Address - Phone:405-769-6767
Mailing Address - Fax:405-769-6775
Practice Address - Street 1:9820 NE 23RD ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73141-4208
Practice Address - Country:US
Practice Address - Phone:405-769-6767
Practice Address - Fax:405-769-6775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-18
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1678111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1CQDCJXMedicare UPIN