# OCCUPATIONAL HEALTH CLINIC LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114295631
- **Authorized official:** MR. DANNY DOUGLAS BRIGGS JR. PA (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (620) 357-5643

## Contact information

- **Practice address:** 601 ATKIN ST, JETMORE, KS 67854-9307
- **Practice address phone:** (620) 357-5643
- **Mailing address:** PO BOX 1697, DODGE CITY, KS 67801-1697
- **Mailing address phone:** (620) 357-5643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | 15-0602 | KS | Yes |

## Other

- **Enumeration date:** 12/12/2011
- **Last updated:** 12/12/2011