Organization
JONAS SPROWLS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONAS ROYCE SPROWLS DC (DOCTOR/OWNER)
(405) 238-4888
Entity
Organization
Contact information
Practice address
2401 W GRANT AVE, SUITE #11, PAULS VALLEY, OK 73075-9243
(405) 238-4888
Mailing address
PO BOX 177, PAULS VALLEY, OK 73075-0177
(405) 238-4888
(405) 238-2103
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3710
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
400522466
MEDICARE GROUP ID#
OK
01
—
446621854
BCBS OF OK ID#
OK
Enumeration date
09/13/2007
Last updated
05/06/2008
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