| Pwwl Centers, Llc | |
|
644 Stateline Rd Colcord OK 74338-1344 | |
| (918) 203-0004 | |
| Not Available |
| Full Name | Pwwl Centers, Llc |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 644 Stateline Rd, Colcord, Oklahoma |
| Authorized Official Name and Position | Jerry Dale Frederiksen (MANAGING MEMBER) |
| Authorized Official Contact | 4794596354 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pwwl Centers, Llc Po Box 6691 Van Buren AR 72956-0601 Ph: (479) 459-6354 | Pwwl Centers, Llc 644 Stateline Rd Colcord OK 74338-1344 Ph: (918) 203-0004 |
| NPI Number | 1154198737 |
|---|---|
| Provider Enumeration Date | 12/05/2023 |
| Last Update Date | 12/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154198737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |