Provider Demographics
NPI:1982902235
Name:ADA FAMILY CHIROPRACTIC P.L.L.C.
Entity Type:Organization
Organization Name:ADA FAMILY CHIROPRACTIC P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:L
Authorized Official - Last Name:HIGNITE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-436-9079
Mailing Address - Street 1:931 ARLINGTON ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:OK
Mailing Address - Zip Code:74820-4025
Mailing Address - Country:US
Mailing Address - Phone:580-436-9079
Mailing Address - Fax:580-436-8204
Practice Address - Street 1:931 ARLINGTON ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ADA
Practice Address - State:OK
Practice Address - Zip Code:74820-4055
Practice Address - Country:US
Practice Address - Phone:580-436-9079
Practice Address - Fax:580-436-8204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-10
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3969111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty