| Procare Healing Centers, Llc | |
|
3501 W Broadway St Muskogee OK 74401-2138 | |
| (866) 306-4461 | |
| (405) 300-1336 |
| Full Name | Procare Healing Centers, Llc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 3501 W Broadway St, Muskogee, Oklahoma |
| Authorized Official Name and Position | Trenton Stillwell (PRESIDENT) |
| Authorized Official Contact | 8663064461 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Procare Healing Centers, Llc 3501 W Broadway St Muskogee OK 74401-2138 Ph: (866) 306-4461 | Procare Healing Centers, Llc 3501 W Broadway St Muskogee OK 74401-2138 Ph: (866) 306-4461 |
| NPI Number | 1437991908 |
|---|---|
| Provider Enumeration Date | 06/06/2024 |
| Last Update Date | 06/10/2025 |
| Medicare PECOS PAC ID | 6204354202 |
|---|---|
| Medicare Enrollment ID | O20250514000415 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437991908 | NPI | - | NPPES |
| Provider Name | Ryan Reynolds |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1114459278 PECOS PAC ID: 9537585989 Enrollment ID: I20220708000238 |
| Provider Name | Michelle Johnson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1912546144 PECOS PAC ID: 8123475266 Enrollment ID: I20231109003862 |
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