Organization
WILLISTON RURAL HEALTH AND WELLNESS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIDNEY ERNEST CLEVINGER M.D. (MEDICAL DIRECTOR)
(352) 266-7075
Entity
Organization
Contact information
Practice address
300 NW 1ST AVE, WILLISTON, FL 32696-2006
(352) 529-0966
(352) 529-0967
Mailing address
300 NW 1ST AVE, WILLISTON, FL 32696-2006
(352) 529-0966
(352) 529-0967
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
03/27/2012
Last updated
10/10/2013
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