Provider Demographics
NPI:1780727545
Name:RANEY FAMILY CHIROPRACTIC CENTRE
Entity type:Organization
Organization Name:RANEY FAMILY CHIROPRACTIC CENTRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BOBI
Authorized Official - Middle Name:LARU
Authorized Official - Last Name:RANEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC, BS
Authorized Official - Phone:918-249-3500
Mailing Address - Street 1:6373 S MEMORIAL DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-1950
Mailing Address - Country:US
Mailing Address - Phone:918-249-3500
Mailing Address - Fax:918-249-3500
Practice Address - Street 1:6373 S MEMORIAL DR
Practice Address - Street 2:SUITE C
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-1950
Practice Address - Country:US
Practice Address - Phone:918-249-3500
Practice Address - Fax:918-249-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3304111N00000X
OK3519111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK=========OtherEIN
OK84237Medicare UPIN