| Team Clinics Ah, Llc | |
|
705 Highway 70 N Kingston OK 73439-8207 | |
| (405) 546-4130 | |
| Not Available |
| Full Name | Team Clinics Ah, Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 705 Highway 70 N, Kingston, Oklahoma |
| Authorized Official Name and Position | Trevor Allen Nutt (CEO) |
| Authorized Official Contact | 4056016767 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Team Clinics Ah, Llc 3112 Cooke Way Oklahoma City OK 73179-2401 Ph: () - | Team Clinics Ah, Llc 705 Highway 70 N Kingston OK 73439-8207 Ph: (405) 546-4130 |
| NPI Number | 1659147973 |
|---|---|
| Provider Enumeration Date | 11/28/2023 |
| Last Update Date | 11/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659147973 | NPI | - | NPPES |
| 200782030 | Medicaid | OK |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
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