Provider Demographics
NPI:1447278239
Name:COOL CHIROPRACTIC CLINIC INC.
Entity type:Organization
Organization Name:COOL CHIROPRACTIC CLINIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:COOL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-747-0011
Mailing Address - Street 1:3315 E 47TH PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-2914
Mailing Address - Country:US
Mailing Address - Phone:918-747-0011
Mailing Address - Fax:918-747-0013
Practice Address - Street 1:3315 E 47TH PL
Practice Address - Street 2:SUITE 100
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2914
Practice Address - Country:US
Practice Address - Phone:918-747-0011
Practice Address - Fax:918-747-0013
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2053111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1780648469Medicare UPIN