# NORTH OKALOOSA CLINIC CORP

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

## Provider details

- **NPI number:** 1477738896
- **Authorized official:** MS. JENNIFER JACKSON (DIRECTOR)
- **Authorized official phone:** (615) 465-3334

## Contact information

- **Practice address:** 550 REDSTONE AVE W, STE. 370, CRESTVIEW, FL 32536-6428
- **Practice address phone:** (850) 682-2209
- **Practice address fax:** (850) 682-2528
- **Mailing address:** PO BOX 689022, FRANKLIN, TN 37068-9022
- **Mailing address phone:** (615) 465-7626
- **Mailing address fax:** (615) 465-3007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | Yes |

## Other

- **Enumeration date:** 01/03/2008
- **Last updated:** 03/18/2022