Provider Demographics
NPI:1811944721
Name:WILLA DUREE, D. OF C., INC.
Entity type:Organization
Organization Name:WILLA DUREE, D. OF C., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUREE
Authorized Official - Suffix:
Authorized Official - Credentials:D C
Authorized Official - Phone:405-275-6363
Mailing Address - Street 1:318 W. HIGHLAND ST.
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74802
Mailing Address - Country:US
Mailing Address - Phone:405-275-6363
Mailing Address - Fax:405-275-6338
Practice Address - Street 1:318 W HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74801-6738
Practice Address - Country:US
Practice Address - Phone:405-275-6363
Practice Address - Fax:405-275-6338
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3767111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1164487229OtherNPI INDENTIFIER