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Individual

DR. PAUL DANIEL ALLSUP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1103 E 13TH ST, SUITE E, GROVE, OK 74344-7928
(918) 787-6116
Mailing address
1103 E 13TH ST, SUITE E, GROVE, OK 74344-7928
(918) 787-6116

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3581
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1959327
FIRST HEALTH PROVIDER NUM
OK
01
7674205
AETNA PROVIDER NUMBER
OK
01
8832439001
CIGNA PROVIDER NUMBER
OK
Enumeration date
07/20/2006
Last updated
07/08/2007
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