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 yesterday at 4:18 PM.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