Organization
BLACKHAWK MANGUM, LLC
Active
Organization
BLACKHAWK MANGUM, LLC
Active
Other names
Quart Mountain Medical Center Imaging Services
Organization subpart
No
Provider details
NPI number
Authorized official
NATALIE YOUNG (CEO)
(580) 782-3353
Entity
Organization
Contact information
Practice address
1 WICKERSHAM ST, MANGUM, OK 73554-9117
(580) 782-3353
Mailing address
1116 N MAIN ST, #12, ALTUS, OK 73521-3149
(580) 477-2674
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2015
Last updated
05/19/2015
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