Organization
JAVERSAK CHIROPRACTIC & SPINE CENTER, INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAYNE ANDREW JAVERSAK BS,DC (OWNER)
(918) 423-1873
Entity
Organization
Contact information
Practice address
1501 WADE WATTS AVE, MCALESTER, OK 74501
(918) 423-1873
(877) 310-9896
Mailing address
1501 WADE WATTS AVE, MCALESTER, OK 74501
(918) 423-1873
(877) 310-9896
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3488
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50390437701
BLUE CROSS BLUE SHIELD
OK
01
—
614305
ACN
OK
Enumeration date
05/09/2007
Last updated
09/16/2010
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