Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NR0400X | Rehabilitation Chiropractor | 3436 | OK |
NPI | 1144389206 |
---|---|
Provider Name | Dr. Ronnie Dean Somerville |
First Address | Oklahoma City, OK 73179-1215 |
Second Address | Oklahoma City, OK 73118-2421 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2006 |
Last Update Date | 29/05/2008 |