| Advanced Chiropractic Center | |
|
523 S Independence St Enid OK 73701-5631 | |
| (580) 237-5007 | |
| (580) 234-6851 |
| Full Name | Advanced Chiropractic Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 523 S Independence St, Enid, Oklahoma |
| Authorized Official Name and Position | John Bradley Eitzen (CHIROPRACTOR) |
| Authorized Official Contact | 5802375007 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Chiropractic Center 523 S Independence St Enid OK 73701-5631 Ph: (580) 237-5007 | Advanced Chiropractic Center 523 S Independence St Enid OK 73701-5631 Ph: (580) 237-5007 |
| NPI Number | 1902942048 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 7911908157 |
|---|---|
| Medicare Enrollment ID | O20070130000720 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902942048 | NPI | - | NPPES |
| 446902380001 | Other | OK | BCBS PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 3805 (Oklahoma) | Primary |
| Provider Name | John B Eitzen |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1215026273 PECOS PAC ID: 9830190073 Enrollment ID: I20070130000712 |
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