Organization
ELLEDGE CHIROPRACTIC CLINIC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CODY THOMAS ELLEDGE D.C. (OWNER/DIRECTOR)
(405) 703-3033
Entity
Organization
Contact information
Practice address
10403 S PENN AVE, OKLAHOMA CITY, OK 73159-6926
(405) 735-9495
Mailing address
10403 S PENN AVE, OKLAHOMA CITY, OK 73159-6926
(405) 735-9495
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3835
OK
Other
Enumeration date
01/29/2008
Last updated
01/29/2008
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