| NPI | 1699963264 |
|---|---|
| Doing Business As | COFFEE CREEK MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | TIMOTHY BRIAN JONES Owner 405-330-1478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2007-10-09 |
| Last Update Date | 2008-02-04 |