Provider Demographics
NPI:1912376609
Name:TRAPP SPINAL CARE, PLLC
Entity Type:Organization
Organization Name:TRAPP SPINAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CONRAD
Authorized Official - Middle Name:LOUIS
Authorized Official - Last Name:TRAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-449-9555
Mailing Address - Street 1:2017 S ELM PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-7034
Mailing Address - Country:US
Mailing Address - Phone:918-449-9555
Mailing Address - Fax:918-449-9559
Practice Address - Street 1:2017 S ELM PL
Practice Address - Street 2:SUITE 100
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-7034
Practice Address - Country:US
Practice Address - Phone:918-449-9555
Practice Address - Fax:918-449-9559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3369111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty