Organization
COUNTRY CARE FAMILY CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHERRY DIANN MITCHELL APRN-CNP (OWNER)
(405) 532-1943
Entity
Organization
Contact information
Practice address
304 W 2ND ST, WELLSTON, OK 74881-9496
(405) 473-7053
(405) 832-1144
Mailing address
PO BOX 5862, EDMOND, OK 73083-5862
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
11/26/2019
Last updated
12/30/2019
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