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Blanton Clinic

Chiropractor in Ponca City, OK. Organization (NPI-2).

NPI number1114101797
StatusActive
Last updated in NPPESDec 19, 2007

Details

NPI
1114101797
Entity type
Organization (NPI-2)
Legal business name
Blanton Clinic
Organization subpart
No
Enumeration date
Dec 19, 2007
Last updated
Dec 19, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
111N00000X Chiropractor––Yes

Practice location

101 E Broadway Ave
Ponca City, OK 74601-4302

Phone 580-765-2482 · Fax 580-765-4852

Mailing address

101 E Broadway Ave
Ponca City, OK 74601-4302

Phone 580-765-2482 · Fax 580-765-4852

Authorized official

Timothy Ray Blanton
Chiropractor/Owner
5807652482

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