Provider Demographics
NPI:1528481843
Name:CROSSROADS CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:CROSSROADS CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:
Authorized Official - Last Name:ROVENSTINE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:918-214-8637
Mailing Address - Street 1:608 SE DELAWARE AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-3615
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:608 SE DELAWARE AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BARTLESVILLE
Practice Address - State:OK
Practice Address - Zip Code:74003-3615
Practice Address - Country:US
Practice Address - Phone:918-214-8637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-22
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4139111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty