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Organization

GRACE DPC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NIKI LEWIS-WYATT PA-C (PRESIDENT)
(580) 307-6263
Entity
Organization

Contact information

Practice address
221 S GRAND AVE, CHEROKEE, OK 73728-2029
(580) 307-6263
(580) 603-8602
Mailing address
221 S GRAND AVE, CHEROKEE, OK 73728-2029
(580) 307-6263
(580) 603-8602

Taxonomy

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

Other

Enumeration date
12/27/2018
Last updated
12/12/2025
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