Grand Lake Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2575 Issued in OK

Legal business name

GRAND LAKE CHIROPRACTIC PLLC

Practice address

240 E 3Rd St
Suite C
Grove, OK 74344-7072

Phone

(918) 786-2442

Fax

(918) 786-2634

NPI assigned

Nov 11, 2008

Last updated

Nov 12, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Douglas L Schnell, D.C.

Title

Owner

Phone

(918) 786-2442

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226448000000",
    "number": "1174777544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 450638",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743450638",
            "telephone_number": "918-786-2442",
            "fax_number": "918-786-2634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 E 3RD ST",
            "address_2": "SUITE C",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743447072",
            "telephone_number": "918-786-2442",
            "fax_number": "918-786-2634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND LAKE CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-11",
        "last_updated": "2008-11-12",
        "status": "A",
        "authorized_official_last_name": "SCHNELL",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-786-2442",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "2575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100724160A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Grove, OK
• Providers in Grove, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.