Individual
DR. DALE WAYNE MAYNARD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
5113 SE 15TH ST STE C, DEL CITY, OK 73115-3952
(405) 601-0700
(405) 605-5776
Mailing address
5113 SE 15TH ST STE C, DEL CITY, OK 73115-3952
(405) 601-0700
(405) 605-5776
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3752
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
432065001-001
BCBS PROVIDER NUMBER
OK
Enumeration date
03/22/2007
Last updated
08/15/2011
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