Provider Demographics
NPI:1922358779
Name:WILBANKS CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:WILBANKS CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:WILBANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-747-0939
Mailing Address - Street 1:3820 E 51ST ST STE A
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-3610
Mailing Address - Country:US
Mailing Address - Phone:918-747-0939
Mailing Address - Fax:918-747-3939
Practice Address - Street 1:3820 E 51ST ST STE A
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-3610
Practice Address - Country:US
Practice Address - Phone:918-747-0939
Practice Address - Fax:918-747-3939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-19
Last Update Date:2012-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4035111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty