Provider Demographics
NPI:1144303082
Name:PEERY, MARK E (DC)
Entity type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:PEERY
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:6117 S MINGO RD
Mailing Address - Street 2:STE- C
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-6315
Mailing Address - Country:US
Mailing Address - Phone:918-615-3433
Mailing Address - Fax:918-615-3453
Practice Address - Street 1:6117 S MINGO RD
Practice Address - Street 2:STE- C
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-6315
Practice Address - Country:US
Practice Address - Phone:918-615-3433
Practice Address - Fax:918-615-3453
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2014-05-27
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Provider Licenses
StateLicense IDTaxonomies
OK3620111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1205939444Medicare PIN