Provider Demographics
NPI:1548441181
Name:VANNARATH, CHRIS A (DC)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:A
Last Name:VANNARATH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 N CLASSEN BLVD
Mailing Address - Street 2:SUITE E
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73106-5422
Mailing Address - Country:US
Mailing Address - Phone:405-314-0900
Mailing Address - Fax:
Practice Address - Street 1:12831 STRATFORD DR
Practice Address - Street 2:APT. #207
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8495
Practice Address - Country:US
Practice Address - Phone:405-314-0900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-26
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3837111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor