Organization
PROACTIVE SPORT AND SPINE PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS J DEARMON D.C. (CHIROPRACTOR)
(918) 254-8700
Entity
Organization
Contact information
Practice address
4412 W HOUSTON ST, BROKEN ARROW, OK 74012-4645
(918) 254-8700
(918) 254-8711
Mailing address
4412 W HOUSTON, BROKEN ARROW, OK 74012
(918) 254-8700
(918) 254-8711
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3846
OK
Other
Enumeration date
04/03/2013
Last updated
04/03/2013
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