Organization
GRAN MIRACLE CHIROPRACTIC INC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PACK L MIRACLE D.C. (PRESIDENT)
(918) 748-9876
Entity
Organization
Contact information
Practice address
3515 E 31ST ST, SUITE C, TULSA, OK 74135-1520
(918) 748-9876
(918) 748-9331
Mailing address
3515 E 31ST ST, SUITE C, TULSA, OK 74135-1520
(918) 748-9876
(918) 748-9331
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2476
OK
Other
Enumeration date
08/28/2007
Last updated
11/28/2007
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