Organization
HEALTHMARK OF WALTON RURAL HEALTH CLINIC INC
Active
Parent organization
HEALTHMARK OF WALTON INC
Other names
Healthmark Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
HEALTHMARK OF WALTON INC
Authorized official
MS. LISA SHIRLEY HOLLEY (COO)
(850) 951-4507
Entity
Organization
Contact information
Practice address
4415 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-6307
(850) 951-4640
(850) 892-7079
Mailing address
4415 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL 32435-6307
(850) 951-4640
(850) 892-7079
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
372384401
—
FL
Enumeration date
11/04/2005
Last updated
09/27/2021
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