Provider Demographics
NPI:1942087341
Name:CLAREMORE CHIROPRACTIC AND REHAB INC.
Entity Type:Organization
Organization Name:CLAREMORE CHIROPRACTIC AND REHAB INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DRAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:GARDNER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-884-9418
Mailing Address - Street 1:9236 N 144TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-2681
Mailing Address - Country:US
Mailing Address - Phone:918-884-9418
Mailing Address - Fax:
Practice Address - Street 1:900 E WILL ROGERS BLVD STE D
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-6307
Practice Address - Country:US
Practice Address - Phone:918-341-6535
Practice Address - Fax:918-341-6566
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty