Provider Demographics
NPI:1972789337
Name:FERRELL CHIROPRACTIC HEALTH CENTER PLLC
Entity Type:Organization
Organization Name:FERRELL CHIROPRACTIC HEALTH CENTER PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROCKY
Authorized Official - Middle Name:G
Authorized Official - Last Name:FERRELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-327-2922
Mailing Address - Street 1:619 CENTER ST
Mailing Address - Street 2:PO BOX 396
Mailing Address - City:ALVA
Mailing Address - State:OK
Mailing Address - Zip Code:73717-0396
Mailing Address - Country:US
Mailing Address - Phone:580-327-2922
Mailing Address - Fax:580-327-3002
Practice Address - Street 1:619 CENTER ST
Practice Address - Street 2:
Practice Address - City:ALVA
Practice Address - State:OK
Practice Address - Zip Code:73717-2215
Practice Address - Country:US
Practice Address - Phone:580-327-2922
Practice Address - Fax:580-327-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2599261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
U28910Medicare UPIN
OKB5049Medicare PIN