Jp Spavinaw Creek Llc | |
401 Center Ave Spavinaw OK 74366-0353 | |
(918) 589-2160 | |
Not Available |
Full Name | Jp Spavinaw Creek Llc |
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Speciality | Counselor - Professional |
Location | 401 Center Ave, Spavinaw, Oklahoma |
Authorized Official Name and Position | Margaret Aileen Plummer (MEMBER/PARTNER) |
Authorized Official Contact | 9185892160 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Jp Spavinaw Creek Llc Po Box 353 401 Center Avenue Spavinaw OK 74366-0353 Ph: (918) 589-2160 | Jp Spavinaw Creek Llc 401 Center Ave Spavinaw OK 74366-0353 Ph: (918) 589-2160 |
NPI Number | 1366795015 |
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Provider Enumeration Date | 10/18/2012 |
Last Update Date | 10/18/2012 |
Identifier | Type | State | Issuer |
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1366795015 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 2502 (Oklahoma) | Primary |
1041C0700X | Social Worker - Clinical | 0053 (Oklahoma) | Secondary |