Organization
GRAND LAKE CHIROPRACTIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS L SCHNELL D.C. (OWNER)
(918) 786-2442
Entity
Organization
Contact information
Practice address
240 E 3RD ST, SUITE C, GROVE, OK 74344-7072
(918) 786-2442
(918) 786-2634
Mailing address
PO BOX 450638, GROVE, OK 74345-0638
(918) 786-2442
(918) 786-2634
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2575
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100724160A
—
OK
Enumeration date
11/11/2008
Last updated
11/12/2008
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