NPI | 1033388509 |
---|---|
Doing Business As | QUARTZ MOUNTAIN MEDICAL CLINIC - MANGUM |
Entity Type | Organization |
Authorized Contact | SHANA DAVENPORT Insurance Credentialing Supervisor 512-681-3460 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: OK 2208) |
Enumeration Date | 2008-02-28 |
Last Update Date | 2009-03-04 |