Aldridge & Dust Enterprises Inc.
Organization Active NPI Chiropractor · Owasso, OK
NPI 1982844494 · NPPES record last updated Jan 21, 2010
Key facts
- NPI
- 1982844494
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 3919 (OK)
- Legal business name
- ALDRIDGE & DUST ENTERPRISES INC.
- Practice address
- 12806 E 101St PL N
Owasso, OK 74055-4662 - Phone
- (918) 376-4243
- Fax
- (918) 376-4249
- NPI assigned
- Feb 23, 2009
- Organization subpart
- No
Authorized official
- Name
- Dr. Travis Edward Dust, D.C.
- Title
- Co-Manager
- Phone
- (918) 408-1166
Practitioners 3
-
Scott Aldridge, D.C.
-
Paul J. Labreche Jr., D.C., P.T.
-
Travis Edward Dust, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OK
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20110725000573 | OK | Part B Supplier - Clinic/Group Practice | 4385812098 |
Receives reassigned benefits from 3 practitioners Practice locations: Owasso, OK |
National Provider Directory
Locations
12806 E 101st Pl N
Owasso, OK 74055
Phone (918) 376-4243
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 3919 | OK | Yes |
| Chiropractor |
111N00000X | 3910 | OK |
Addresses
Primary practice location
12806 E 101St PL N
Owasso, OK 74055-4662
Mailing address
12806 E 101St PL N
Owasso, OK 74055-4662
Other names
- Elite Performance & Rehabilitation
Other providers in Owasso, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 21, 2010. 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.