Organization
MID-DEL CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DALE WAYNE MAYNARD JR. D.C. (OWNER)
(405) 601-0700
Entity
Organization
Contact information
Practice address
5113 SE 15TH ST STE C, DEL CITY, OK 73115-3952
(405) 601-0700
(405) 605-5776
Mailing address
5113 SE 15TH ST STE C, DEL CITY, OK 73115-3952
(405) 601-0700
(405) 605-5776
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3752
OK
Other
Enumeration date
08/17/2011
Last updated
11/21/2011
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