Provider Demographics
NPI:1427329549
Name:TRACY CALAMAIO DC PC
Entity type:Organization
Organization Name:TRACY CALAMAIO DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRACY
Authorized Official - Middle Name:L
Authorized Official - Last Name:CALAMAIO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:405-728-3138
Mailing Address - Street 1:7640 NW EXPRESSWAY
Mailing Address - Street 2:SUITE 204
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-1620
Mailing Address - Country:US
Mailing Address - Phone:405-728-3138
Mailing Address - Fax:405-728-9107
Practice Address - Street 1:7640 NW EXPRESSWAY
Practice Address - Street 2:SUITE 204
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-1620
Practice Address - Country:US
Practice Address - Phone:405-728-3138
Practice Address - Fax:405-728-9107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-20
Last Update Date:2012-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3209111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U56690Medicare UPIN