Organization
RECLAIM WELLNESS LLC
Active
Other names
Reclaim Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
TRACYE FOWLER NP (PROVIDER OWNER)
(405) 819-5884
Entity
Organization
Contact information
Practice address
10932 NW EXPRESSWAY STE C, YUKON, OK 73099-8764
(405) 570-1010
(949) 660-5841
Mailing address
10932 NW EXPRESSWAY STE C, YUKON, OK 73099-8764
(405) 570-1010
(949) 660-5841
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200657160
—
OK
Enumeration date
05/16/2022
Last updated
09/06/2022
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