Organization
IMPACT CHIROPRACTIC CLINIC INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KELLEY D DEHNHARDT (OFFICE MANAGER)
(918) 893-6400
Entity
Organization
Contact information
Practice address
4705 W URBANA ST, BROKEN ARROW, OK 74012-5998
(918) 893-6400
(918) 893-6402
Mailing address
4705 W URBANA, BROKEN ARROW, OK 74012-5998
(918) 893-6400
(918) 893-6402
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2589
OK
Other
Enumeration date
04/25/2007
Last updated
12/15/2009
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