Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 4350 | OK |
N | 111NP0017X | Pediatric Chiropractor | 4350 | OK |
NPI | 1487292223 |
---|---|
Provider Name | Dr. Danielle Ashley Reif |
First Address | Tulsa, OK 74104-4610 |
Second Address | Claremore, OK 74017-5618 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2019 |
Last Update Date | 06/04/2021 |