Organization
BACK PAIN BOOT CAMP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DARRICK DAVIS DC (OWNER)
(918) 258-2225
Entity
Organization
Contact information
Practice address
920 S ELM PL, BROKEN ARROW, OK 74012-5372
(918) 258-2225
(918) 251-6624
Mailing address
920 S ELM PL, BROKEN ARROW, OK 74012-5372
(918) 258-2225
(918) 251-6624
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3203
OK
Other
Enumeration date
02/12/2008
Last updated
02/12/2008
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