| Northeast Oklahoma Wellness Clinic Llc | |
|
1500 E Downing St Tahlequah OK 74464-3234 | |
| (918) 456-2594 | |
| (918) 456-3395 |
| Full Name | Northeast Oklahoma Wellness Clinic Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1500 E Downing St, Tahlequah, Oklahoma |
| Authorized Official Name and Position | Keven Partin (OWNER) |
| Authorized Official Contact | 9188936201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeast Oklahoma Wellness Clinic Llc 6312 E 101st St Tulsa OK 74137-7007 Ph: (918) 893-6201 | Northeast Oklahoma Wellness Clinic Llc 1500 E Downing St Tahlequah OK 74464-3234 Ph: (918) 456-2594 |
| NPI Number | 1568823938 |
|---|---|
| Provider Enumeration Date | 03/14/2016 |
| Last Update Date | 03/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568823938 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Oklahoma) | Primary |
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