Organization
BRADLEY A HEIMER, LLC
Active
Other names
580 Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
BETTI R ESTEP (CREDENTIALING/BILLING MGR)
(405) 521-1969
Entity
Organization
Contact information
Practice address
1201 ARLINGTON ST STE A, ADA, OK 74820-4072
(580) 436-7173
(580) 436-7176
Mailing address
PO BOX 269031, OKLAHOMA CITY, OK 73126-9031
(405) 521-1969
(405) 521-1979
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4081
OK
Other
Enumeration date
09/14/2012
Last updated
12/13/2016
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