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1568823938
NORTHEAST OKLAHOMA WELLNESS CLINIC LLC
TAHLEQUAH, OK
NPI
1568823938
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Entity Type
Organization
Authorized Contact
KEVEN PARTIN
Owner
918-893-6201
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2016-03-14
Last Update Date
2016-03-14
Business Address
NORTHEAST OKLAHOMA WELLNESS CLINIC LLC
1500 E DOWNING ST
TAHLEQUAH, OK 74464-3234
Phone number: 918-456-2594
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Mailing Address
NORTHEAST OKLAHOMA WELLNESS CLINIC LLC
6312 E 101ST ST
TULSA, OK 74137-7007
Phone number: 918-893-6201
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