Individual
DR. ROGER ALLEN DIVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
910 E 1ST ST, CHANDLER, OK 74834-2404
(405) 258-0014
(405) 258-0094
Mailing address
PO BOX 128, CHANDLER, OK 74834-0128
(405) 258-0014
(405) 258-0094
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3592
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00135785 DB9021
RAILROAD MEDICARE
OK
Enumeration date
07/24/2006
Last updated
03/09/2015
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