Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 3139 | OK |
NPI | 1639242647 |
---|---|
Provider Name | Dr. Susan L. Chung |
First Address | Oklahoma City, OK 73132-3514 |
Second Address | Oklahoma City, OK 73132-3514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U46857 | (02) | OK |