OrganizationJaversak Chiropractic & Spine Center, Inc PcChiropractorChiropractic ProvidersPractice Address1501 Wade Watts Ave, Mcalester, OK 74501(918) 423-1873PECOS EnrollmentBased on the most recent information from CMS, provider Javersak Chiropractic & Spine Center, Inc Pc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1649484627Provider TypeOrganizationFull NameJaversak Chiropractic & Spine Center, Inc PcSubpartNoEnumeration Date5/9/2007Last Updated9/16/2010Contact InformationPractice LocationPractice Address1501 Wade Watts Ave, Mcalester, OK 74501Phone(918) 423-1873Fax(877) 310-9896Mailing LocationMailing Address1501 Wade Watts Ave, Mcalester, OK 74501Phone(918) 423-1873Fax(877) 310-9896Authorized OfficialNameJaversak, Shayne Andrew (Owner)Phone(918) 423-1873Provider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicense3488OklahomaProvider IdentifiersIDDescriptionIssuerID50390437701DescriptionOtherIssuerBLUE CROSS BLUE SHIELDOklahomaID614305DescriptionOtherIssuerACNOklahoma