Organization
VICTORY SPINAL CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERED WAYLAND DC (OWNER)
(918) 366-7100
Entity
Organization
Contact information
Practice address
5085 E 151ST ST S STE B, BIXBY, OK 74008-4016
(918) 366-7100
Mailing address
1424 KURRE LN, CAPE GIRARDEAU, MO 63701-2254
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
—
Other
Enumeration date
12/13/2024
Last updated
12/13/2024
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