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1114260593
PROACTIVE SPORT AND SPINE PLC
BROKEN ARROW, OK
NPI
1114260593
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Entity Type
Organization
Authorized Contact
TRAVIS J DEARMON
Chiropractor
918-254-8700
Organization Subpart ?
No
Primary Taxonomy
111N00000X Chiropractor
(Licence: OK 3846)
Enumeration Date
2013-04-03
Last Update Date
2013-04-03
Business Address
PROACTIVE SPORT AND SPINE PLC
4412 W HOUSTON ST
BROKEN ARROW, OK 74012-4645
Phone number: 918-254-8700
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Mailing Address
PROACTIVE SPORT AND SPINE PLC
4412 W HOUSTON
BROKEN ARROW, OK 74012
Phone number: 918-254-8700
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