Organization
WIERSIG CHIROPRACTIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICKY DARREN WIERSIG (OWNER)
(405) 737-5653
Entity
Organization
Contact information
Practice address
2013 S. AIR DEPOT BLVD, MIDWEST CITY, OK 73110-5523
(405) 737-5653
(405) 733-5656
Mailing address
2013 S. AIR DEPOT BLVD, MIDWEST CITY, OK 73110-5523
(405) 737-5653
(405) 733-5656
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
3048
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OKA102034
PTAN
OK
Enumeration date
11/02/2010
Last updated
12/20/2010
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