Provider Demographics
NPI:1891002838
Name:FAMILY HEALTH CHIROPRACTIC, INC. P.C.
Entity Type:Organization
Organization Name:FAMILY HEALTH CHIROPRACTIC, INC. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:BUTTS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-364-7800
Mailing Address - Street 1:PO BOX 1152
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73070-1152
Mailing Address - Country:US
Mailing Address - Phone:405-364-7800
Mailing Address - Fax:405-364-7820
Practice Address - Street 1:519 E ROBINSON ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73071-6614
Practice Address - Country:US
Practice Address - Phone:405-364-7800
Practice Address - Fax:405-364-7820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-13
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3814111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOKA103011Medicare PIN