| Green Country Spine & Sport, Pllc | |
|
803 N Foreman St, Vinita, OK 74301-1435 | |
| (918) 256-5111 | |
| (918) 256-5222 |
| Full Name | Green Country Spine & Sport, Pllc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 803 N Foreman St, Vinita, Oklahoma |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942586706 | NPI | - | NPPES |
| 200449820A | Medicaid | OK | |
| OKAAA2678 | Other | OK | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | 4016 (Oklahoma) | Primary |
| Provider Name | Joseph Clark |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1750304481 PECOS PAC ID: 7315979945 Enrollment ID: I20111205000083 |
| Mailing Address | Practice Location Address |
|---|---|
| Green Country Spine & Sport, Pllc Po Box 248, Vinita, OK 74301-0248 Ph: (918) 256-5111 | Green Country Spine & Sport, Pllc 803 N Foreman St, Vinita, OK 74301-1435 Ph: (918) 256-5111 |
Mr. Daniel P Day, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 1558 E North Ridge Dr, Vinita, OK 74301 Phone: 918-915-0312 | |
Dr. Jack Benson Weems, DC Chiropractor Medicare: Not Enrolled in Medicare Practice Location: 467 South Wilson, Vinita, OK 74301 Phone: 918-256-8744 Fax: 918-256-8747 | |
Joseph C. Clark, D.C. Chiropractor Medicare: Accepting Medicare Assignments Practice Location: 803 N Foreman St, Vinita, OK 74301 Phone: 918-256-5111 Fax: 918-256-5222 |