Provider Demographics
NPI:1992561757
Name:CHIROPRACTIC NEUROLOGY SERVICES, PLLC
Entity type:Organization
Organization Name:CHIROPRACTIC NEUROLOGY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:INGLESE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:239-896-0974
Mailing Address - Street 1:PO BOX 20173
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73156-0173
Mailing Address - Country:US
Mailing Address - Phone:239-896-0974
Mailing Address - Fax:
Practice Address - Street 1:3120 W BRITTON RD STE 201
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-2038
Practice Address - Country:US
Practice Address - Phone:239-896-0974
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-27
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty