Organization
GTZ AND ENK
Active
Other names
CLINICA DE SALUD Y BIENESTAR HISPANO
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH LOUISE BANDA APRN (VICE PRESIDENT)
(918) 647-7100
Entity
Organization
Contact information
Practice address
2706 N BROADWAY ST, POTEAU, OK 74953-5402
(918) 647-7100
(918) 647-7101
Mailing address
2706 N BROADWAY ST, POTEAU, OK 74953-5402
(918) 647-7100
(918) 647-7101
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200597420A
—
OK
Enumeration date
05/03/2016
Last updated
05/03/2016
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