Provider Demographics
NPI:1508016098
Name:SHENLOOGIAN CHIROPRACTIC & ACUPUNCTURE CLINIC, LLC
Entity Type:Organization
Organization Name:SHENLOOGIAN CHIROPRACTIC & ACUPUNCTURE CLINIC, LLC
Other - Org Name:SHENLOOGIAN CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:SHENLOOGIAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-645-0838
Mailing Address - Street 1:4146 S HARVARD AVE
Mailing Address - Street 2:SUITE F-2
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2610
Mailing Address - Country:US
Mailing Address - Phone:918-933-5445
Mailing Address - Fax:918-933-5446
Practice Address - Street 1:4146 S HARVARD AVE
Practice Address - Street 2:SUITE F-2
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2610
Practice Address - Country:US
Practice Address - Phone:918-933-5445
Practice Address - Fax:918-933-5446
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-22
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty