| Spine Spa Pllc | |
|
7302 S Yale Ave, Tulsa, OK 74136-7027 | |
| (918) 671-8805 | |
| Not Available |
| Full Name | Spine Spa Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 7302 S Yale Ave, Tulsa, Oklahoma |
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376046433 | NPI | - | NPPES |
| PTAN587456AD7U | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4231 (Oklahoma) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Spine Spa Pllc 7302 S Yale Ave, Tulsa, OK 74136-7027 Ph: (918) 671-8805 | Spine Spa Pllc 7302 S Yale Ave, Tulsa, OK 74136-7027 Ph: (918) 671-8805 |
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