Back & Neck Clinic, PC
Organization Active NPI Chiropractor · Sapulpa, OK
NPI 1801024914 · NPPES record last updated Jun 26, 2009
Key facts
- NPI
- 1801024914
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2232 (OK)
- Legal business name
- BACK & NECK CLINIC, PC
- Practice address
- 1036 E Taft St
Sapulpa, OK 74066-5731 - Phone
- (918) 224-0546
- Fax
- (918) 347-5551
- NPI assigned
- Jun 26, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Kim K Chai, DC
- Title
- President
- Phone
- (918) 224-0546
Practitioners 2
-
Kim K Chai, D.C.
-
Jeremiah Kamalani Chai, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090827000452 | OK | Part B Supplier - Clinic/Group Practice | 5092860049 |
Receives reassigned benefits from 1 practitioner Practice locations: Sapulpa, OK |
National Provider Directory
Locations
1036 E Taft Ave
Sapulpa, OK 74066
Phone (918) 224-0546
808 E Taft Ave
Ste C
Sapulpa, OK 74066
Phone (918) 224-0546
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2232 | OK | Yes |
Addresses
Primary practice location
1036 E Taft St
Sapulpa, OK 74066-5731
Mailing address
1036 E Taft St
Sapulpa, OK 74066-5731
Phone (918) 224-0546
Other providers in Sapulpa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 26, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.