Provider Demographics
NPI:1487292223
Name:REIF, DANIELLE ASHLEY (DC)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ASHLEY
Last Name:REIF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1815 E 15TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4610
Mailing Address - Country:US
Mailing Address - Phone:918-401-0377
Mailing Address - Fax:
Practice Address - Street 1:402 N LYNN RIGGS BLVD
Practice Address - Street 2:
Practice Address - City:CLAREMORE
Practice Address - State:OK
Practice Address - Zip Code:74017-5618
Practice Address - Country:US
Practice Address - Phone:918-343-2243
Practice Address - Fax:918-343-2249
Is Sole Proprietor?:Yes
Enumeration Date:2019-12-11
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4350111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor