Organization
THACKERVILLE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. DANA CAROL SPROTT ARNP (NURSE PRACTITIONER/OWNER)
(940) 366-0180
Entity
Organization
Contact information
Practice address
11530 RIDGE RD STE 1, THACKERVILLE, OK 73459-9771
(580) 276-9066
(580) 276-9063
Mailing address
11530 RIDGE RD STE 1, THACKERVILLE, OK 73459-9771
(580) 276-9066
(580) 276-9063
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R0096598
OK
Other
Enumeration date
04/07/2010
Last updated
04/12/2012
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