Provider Demographics
NPI:1811546260
Name:CASE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:CASE CHIROPRACTIC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC
Authorized Official - Prefix:
Authorized Official - First Name:CASEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CONRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-699-5115
Mailing Address - Street 1:1818 W GORE BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73501-3615
Mailing Address - Country:US
Mailing Address - Phone:580-699-5115
Mailing Address - Fax:580-699-5120
Practice Address - Street 1:1818 W GORE BLVD STE B
Practice Address - Street 2:
Practice Address - City:LAWTON
Practice Address - State:OK
Practice Address - Zip Code:73501-3615
Practice Address - Country:US
Practice Address - Phone:580-699-5115
Practice Address - Fax:580-699-5120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-09
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty