Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 3534 | OK |
N | 111NX0100X | Occupational Health | 3534 | OK |
N | 111NX0800X | Chiropractor Orthopedic Specialist | 3534 | OK |
NPI | 1619983392 |
---|---|
Provider Name | Opal Juanita Garman |
First Address | Tulsa, OK 74105-4563 |
Second Address | Tulsa, OK 74105-4563 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 08/07/2007 |