Provider Demographics
NPI:1265800015
Name:SCHOLLE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:SCHOLLE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MITSUKO
Authorized Official - Middle Name:DEANA
Authorized Official - Last Name:SCHOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-933-5270
Mailing Address - Street 1:2251 E SKELLY DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105-6062
Mailing Address - Country:US
Mailing Address - Phone:918-933-5270
Mailing Address - Fax:918-933-5246
Practice Address - Street 1:2251 E SKELLY DR
Practice Address - Street 2:SUITE 101
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74105-6062
Practice Address - Country:US
Practice Address - Phone:918-933-5270
Practice Address - Fax:918-933-5246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-10
Last Update Date:2015-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3956305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization