Provider Demographics
NPI:1053971598
Name:OKUN, GARRETT MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:GARRETT
Middle Name:MICHAEL
Last Name:OKUN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:710 N BEAVER ST BLDG 3
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-3147
Mailing Address - Country:US
Mailing Address - Phone:282-261-5569
Mailing Address - Fax:855-821-1779
Practice Address - Street 1:1585 S PLAZA WAY STE 150
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-7156
Practice Address - Country:US
Practice Address - Phone:928-226-1556
Practice Address - Fax:855-821-1779
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR010224111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor