Provider Demographics
NPI:1942263504
Name:COLE, CHRISTOPHER K (DC)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:K
Last Name:COLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5960 S 298TH EAST AVE
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74014-8405
Mailing Address - Country:US
Mailing Address - Phone:918-664-2273
Mailing Address - Fax:918-664-2204
Practice Address - Street 1:5424 S MEMORIAL DR
Practice Address - Street 2:SUITE B-2
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-9003
Practice Address - Country:US
Practice Address - Phone:918-664-2273
Practice Address - Fax:918-664-2204
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3202111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU55239Medicare UPIN