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Organization

MAIN STREET FAMILY CLINIC LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BETH HOLDERBY APRN (OWNER)
(580) 551-9131
Entity
Organization

Contact information

Practice address
213 W MAIN ST, CANTON, OK 73724-1234
(405) 506-9101
(405) 936-0561
Mailing address
PO BOX 57390, OKLAHOMA CITY, OK 73157-7390
(405) 506-9101
(405) 936-0561

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Enumeration date
05/23/2025
Last updated
07/09/2025
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