Organization
STANDRIDGE CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY L STANDRIDGE D.C. (OWNER)
(918) 272-7432
Entity
Organization
Contact information
Practice address
12707 E 86TH ST N, OWASSO, OK 74055-2506
(918) 272-7432
(918) 272-7448
Mailing address
12707 E. 86TH ST. N., OWASSO, OK 74055
(918) 272-7432
(918) 272-7448
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
2448
OK
Other
Enumeration date
12/14/2006
Last updated
03/29/2010
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