Organization
PRENTICE FAMILY CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY MARIE PRENTICE (OFFICE MANAGER)
(918) 296-0525
Entity
Organization
Contact information
Practice address
9428 S ELWOOD AVE, SUITE 102, JENKS, OK 74037-2317
(918) 296-0525
(918) 296-0526
Mailing address
9428 S ELWOOD AVE, SUITE 102, JENKS, OK 74037-2317
(918) 296-0525
(918) 296-0526
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3725
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
443769532002
BLUE CROSS BLUE SHIELD
OK
Enumeration date
11/22/2006
Last updated
08/22/2020
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