Organization
GO LIGHTLY CHIROPRACTIC REVOLUTION WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SETH CHARLES RAYE MILLER DO (CHIROPRACTIC/OWNER)
(580) 382-4560
Entity
Organization
Contact information
Practice address
205 E GRAND AVE, PONCA CITY, OK 74601-4318
(580) 382-4560
(580) 382-4360
Mailing address
205 E GRAND AVE, PONCA CITY, OK 74601-4318
(580) 382-4560
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4211
OK
Other
Enumeration date
03/21/2017
Last updated
09/24/2024
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