TTD Management Trust

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

TTD MANAGEMENT TRUST

Doing business as

Grove Chiropractic Clinic

Practice address

901 S Main St
Grove, OK 74344-2845

Phone

(918) 786-1056

NPI assigned

Jun 3, 2008

Organization subpart

No

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

Authorized official

Name

Mrs. Sara Pennell, D.C.

Title

Owner

Phone

(918) 786-1056

Specialties & licenses 2

Addresses

Other names 1

• Grove Chiropractic Clinic Doing business as

Locations

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212451200000",
    "number": "1629237904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 S MAIN ST",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743442845",
            "telephone_number": "918-786-1056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 S MAIN ST",
            "city": "GROVE",
            "state": "OK",
            "postal_code": "743442845",
            "telephone_number": "918-786-1056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TTD MANAGEMENT TRUST",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2008-06-03",
        "status": "A",
        "authorized_official_last_name": "PENNELL",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "918-786-1056",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "2637",
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grove Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Tyson Richard Trimble, D.O.
• Charles A Tullis, CFA
• Alison C Tuttle, PA-C
• Marcia D. Tynon, L.D.
• Urgent Care of Grand Lake PLLC
• Raegan Vaughan, DDS

• Clinic/Center in Grove, OK
• Providers in Grove, OK by specialty
• Clinic/Center in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 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.