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Individual

ANDREW OBANNON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
3250 MAPLE AVE, TERRE HAUTE, IN 47804-1727
(812) 462-5799
Mailing address
2424 CROSSING DR, EDMOND, OK 73013-6959

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08003127A
IN
111N00000X
Chiropractor
4318
OK

Other

Enumeration date
03/25/2019
Last updated
11/11/2019
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