Countryside Wellness LLC

NPI #1205142700 in Tahlequah, Oklahoma

Provider Information

NPI Number: 1205142700
Entity Type: Organization
Organization Name: Countryside Wellness LLC
Primary Specialty: Chiropractor
Enumeration Date: Aug 23, 2010
Last Updated: Sep 5, 2024

Practice Location

Address: 2067 MAHANEY AVE
City: Tahlequah
State: Oklahoma
ZIP Code: 74464-5731
Phone: (918) 708-2563

Authorized Official

Name: KELLY J CALLAWAY, DC
Title: OWNER/CHIROPRACTOR
Phone: (918) 708-2563

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X	Primary

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