Provider Demographics
NPI:1669683371
Name:DR DEBORA K BALFOUR CHIROPRACTIC PHYSICIAN PC
Entity type:Organization
Organization Name:DR DEBORA K BALFOUR CHIROPRACTIC PHYSICIAN PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTIC PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BALFOUR-SAUL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-692-4885
Mailing Address - Street 1:8501 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73159-5206
Mailing Address - Country:US
Mailing Address - Phone:405-692-4885
Mailing Address - Fax:405-681-0903
Practice Address - Street 1:8501 S PENNSYLVANIA
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159
Practice Address - Country:US
Practice Address - Phone:405-692-4885
Practice Address - Fax:405-681-0903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20060126111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedicGroup - Single Specialty