Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2585 | OK |
N | 111NN1001X | Nutrition | 2585 | OK |
N | 111NR0200X | Radiology | 2585 | OK |
N | 213ER0200X | Radiology | 2585 | OK |
N | 111NR0400X | Rehabilitation Chiropractor | 2585 | OK |
Y | 111NS0005X | Chiropractic Sports Physician | 2585 | OK |
NPI | 1619956554 |
---|---|
Provider Name | Viki White |
First Address | Enid, OK 73701 |
Second Address | Enid, OK 73703-2524 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2006 |
Last Update Date | 29/09/2020 |