Provider Demographics
NPI:1891990883
Name:DR JILLS CHIROPRACTIC CARE CENTER PLLC
Entity Type:Organization
Organization Name:DR JILLS CHIROPRACTIC CARE CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.C./ MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JILL
Authorized Official - Middle Name:A
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-549-6932
Mailing Address - Street 1:PO BOX 754
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:OK
Mailing Address - Zip Code:73538-0754
Mailing Address - Country:US
Mailing Address - Phone:580-549-6932
Mailing Address - Fax:580-549-6057
Practice Address - Street 1:102 N CENTRAL
Practice Address - Street 2:
Practice Address - City:FLETCHER
Practice Address - State:OK
Practice Address - Zip Code:73541
Practice Address - Country:US
Practice Address - Phone:580-549-6932
Practice Address - Fax:580-549-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-19
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3187111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty