Organization
CCM CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLINTON C. MOORE D. C. (CHIROPRACTOR)
(918) 479-2827
Entity
Organization
Contact information
Practice address
413 E MAIN ST, LOCUST GROVE, OK 74352
(918) 479-2827
Mailing address
PO BOX 1471, LOCUST GROVE, OK 74352-1471
(918) 479-2827
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3649
OK
Other
Enumeration date
04/19/2010
Last updated
04/19/2010
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