Provider Demographics
NPI:1841223112
Name:KAISER CHIROPRACTIC, LLC
Entity Type:Organization
Organization Name:KAISER CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:HOFFMAN
Authorized Official - Last Name:KAISER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-376-5700
Mailing Address - Street 1:251 S CASTLEROCK LN
Mailing Address - Street 2:
Mailing Address - City:MUSTANG
Mailing Address - State:OK
Mailing Address - Zip Code:73064-4583
Mailing Address - Country:US
Mailing Address - Phone:405-376-5700
Mailing Address - Fax:405-376-4200
Practice Address - Street 1:251 S CASTLEROCK LN
Practice Address - Street 2:
Practice Address - City:MUSTANG
Practice Address - State:OK
Practice Address - Zip Code:73064-4583
Practice Address - Country:US
Practice Address - Phone:405-376-5700
Practice Address - Fax:405-376-4200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3226111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU92716Medicare UPIN