| NPI | 1114421492 |
|---|---|
| Doing Business As | GREAT PLAINS PAT WALL CLINIC |
| Entity Type | Organization |
| Authorized Contact | COREY LIVELY CEO 580-821-5300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2018-05-10 |