| Renew Chiropractic Llc | |
|
7319 Northshore Dr Tuttle OK 73089-8994 | |
| (405) 237-5812 | |
| Not Available |
| Full Name | Renew Chiropractic Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7319 Northshore Dr, Tuttle, Oklahoma |
| Authorized Official Name and Position | Katherine Locke (MANAGING MEMBER, CHIROPRACTOR) |
| Authorized Official Contact | 4052375812 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Renew Chiropractic Llc 7319 Northshore Dr Tuttle OK 73089-8994 Ph: (405) 237-5812 | Renew Chiropractic Llc 7319 Northshore Dr Tuttle OK 73089-8994 Ph: (405) 237-5812 |
| NPI Number | 1093593055 |
|---|---|
| Provider Enumeration Date | 09/20/2023 |
| Last Update Date | 09/20/2023 |
| Medicare PECOS PAC ID | 6103275896 |
|---|---|
| Medicare Enrollment ID | O20231206002588 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093593055 | NPI | - | NPPES |
| 1811585037 | Other | OK | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Katherine Elizabeth Locke |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1811585037 PECOS PAC ID: 6204240674 Enrollment ID: I20210126001196 |
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