GREEN COUNTRY SPINE & SPORT PLLC NPI 1942586706

NPI Information

  • NPI: 1942586706
  • Provider Name: GREEN COUNTRY SPINE & SPORT, PLLC
  • Classification: Chiropractor - 111N00000X
  • Entity Type: Organization
  • Address: 803 N FOREMAN ST
    VINITA, OK
    ZIP 74301
  • Phone: (918) 256-5111

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NPI Details

GREEN COUNTRY SPINE & SPORT, PLLC is a chiropractor in Vinita, OK. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. GREEN COUNTRY SPINE & SPORT, PLLC NPI is 1942586706. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

803 N FOREMAN ST
VINITA, OK
ZIP 74301-435
Phone: (918) 256-5111
Fax: (918) 256-5222

The provider's authorized official is Joseph Clark .
The authorized official title is Owner and has the following contact phone number (918) 256-5111.

The enumeration date for this NPI number is 10/25/2011 and was last updated on 8/27/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1111N00000XChiropractor4016OKLAHOMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200449820AMEDICAIDOKLAHOMA
2OKAAA2678OTHEROKLAHOMAMEDICARE PTAN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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