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Organization
WILLISTON RURAL HEALTH AND WELLNESS CLINIC LLC
Active
Organization
WILLISTON RURAL HEALTH AND WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIDNEY ERNEST CLEVINGER M.D. (MEDICAL DIRECTOR)
(352) 266-7075
Entity
Organization
Contact information
Practice address
300 NW 1ST AVE, WILLISTON, FL 32696-2006
(352) 529-0966
(352) 529-0967
Mailing address
300 NW 1ST AVE, WILLISTON, FL 32696-2006
(352) 529-0966
(352) 529-0967
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
03/27/2012
Last updated
10/10/2013
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