Provider Demographics
NPI:1720171127
Name:ADVANCED SPINAL CARE & ALTERNATIVE HEALING ARTS, PC
Entity Type:Organization
Organization Name:ADVANCED SPINAL CARE & ALTERNATIVE HEALING ARTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TAMMALA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-637-7396
Mailing Address - Street 1:7351 E 131ST ST S
Mailing Address - Street 2:
Mailing Address - City:BIXBY
Mailing Address - State:OK
Mailing Address - Zip Code:74008-3159
Mailing Address - Country:US
Mailing Address - Phone:918-637-7396
Mailing Address - Fax:
Practice Address - Street 1:7351 E 131ST ST S
Practice Address - Street 2:
Practice Address - City:BIXBY
Practice Address - State:OK
Practice Address - Zip Code:74008-3159
Practice Address - Country:US
Practice Address - Phone:918-637-7396
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty