Provider Demographics
NPI:1043513096
Name:ALSUP-BRIGGS INC
Entity type:Organization
Organization Name:ALSUP-BRIGGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WYLIE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRIGGS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-262-1300
Mailing Address - Street 1:1141 SW 44TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3601
Mailing Address - Country:US
Mailing Address - Phone:405-634-1304
Mailing Address - Fax:405-634-1007
Practice Address - Street 1:1141 SW 44TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3601
Practice Address - Country:US
Practice Address - Phone:405-634-1304
Practice Address - Fax:405-634-1007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-14
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3422111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKU69449Medicare UPIN