Provider Demographics
NPI:1881753937
Name:NATURAL CARE CHIROPRACTIC CLINIC INC PC
Entity type:Organization
Organization Name:NATURAL CARE CHIROPRACTIC CLINIC INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:MCKINNEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-485-1973
Mailing Address - Street 1:PO BOX 1096
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74477-1096
Mailing Address - Country:US
Mailing Address - Phone:918-485-1973
Mailing Address - Fax:918-485-1979
Practice Address - Street 1:508 E CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:WAGONER
Practice Address - State:OK
Practice Address - Zip Code:74467-4710
Practice Address - Country:US
Practice Address - Phone:918-485-1973
Practice Address - Fax:918-485-1979
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3438111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU69550Medicare UPIN