Provider Demographics
NPI:1124680079
Name:ARBUCKLE CHIROPRACTIC LLC
Entity type:Organization
Organization Name:ARBUCKLE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLANDENSHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:580-622-5959
Mailing Address - Street 1:1500 W. 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SULPHUR
Mailing Address - State:OK
Mailing Address - Zip Code:73086
Mailing Address - Country:US
Mailing Address - Phone:580-622-5959
Mailing Address - Fax:580-622-6108
Practice Address - Street 1:1500 W. 1ST ST
Practice Address - Street 2:
Practice Address - City:SULPHUR
Practice Address - State:OK
Practice Address - Zip Code:73086
Practice Address - Country:US
Practice Address - Phone:580-622-5959
Practice Address - Fax:580-622-6108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty