Full Name | |
---|---|
Speciality | Clinic/center |
Location | 10 S Treaty Rd, Miami, Oklahoma |
Authorized Official Name and Position | Steven Chase (CEO) |
Authorized Official Contact | 9182567551 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 326 Vinita OK 74301-0326 Ph: (918) 256-7551 | 10 S Treaty Rd Miami OK 74354-5330 Ph: (918) 542-6644 |
NPI Number | 1770752800 |
---|---|
Provider Enumeration Date | 02/22/2008 |
Last Update Date | 02/12/2013 |
Identifier | Type | State | Issuer |
---|---|---|---|
1770752800 | NPI | - | NPPES |
100261400J | Medicaid | OK |
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