| Jp Spavinaw Creek Llc | |
|
401 Center Ave Spavinaw OK 74366-0353 | |
| (918) 589-2160 | |
| Not Available |
| Full Name | Jp Spavinaw Creek Llc |
|---|---|
| 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 |
|---|---|
| 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 |
|---|---|
| Provider Enumeration Date | 10/18/2012 |
| Last Update Date | 10/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366795015 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 0053 (Oklahoma) | Secondary |
| 101YP2500X | Counselor - Professional | 2502 (Oklahoma) | Primary |