Provider Demographics
NPI:1013520733
Name:CENTER FOR JOINT RELIEF LLC
Entity Type:Organization
Organization Name:CENTER FOR JOINT RELIEF LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:A
Authorized Official - Last Name:MANNING
Authorized Official - Suffix:
Authorized Official - Credentials:MSPT
Authorized Official - Phone:405-706-1266
Mailing Address - Street 1:10325 GREENBRIAR PL STE B
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-7647
Mailing Address - Country:US
Mailing Address - Phone:405-759-7719
Mailing Address - Fax:405-759-7718
Practice Address - Street 1:10325 GREENBRIAR PL STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-7647
Practice Address - Country:US
Practice Address - Phone:405-759-7719
Practice Address - Fax:405-759-7718
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-24
Last Update Date:2020-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental MedicineGroup - Multi-Specialty