Organization
ST. MADRON MEDICAL CLINIC
Active
Other names
Wellness Clinic of Roland Inc
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN BREWER (OWNER)
(918) 503-6235
Entity
Organization
Contact information
Practice address
205 E. RAY FINE BLVD ST. 6, ROLAND, OK 74954
(918) 503-6235
(918) 398-0637
Mailing address
303 TOWSON AVE., FORT SMITH, AR 72901
(918) 503-6235
(918) 398-0637
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
17754
OK
Other
Enumeration date
09/03/2013
Last updated
08/06/2015
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