Organization
TEAM CLINICS AH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TREVOR NUTT (CEO)
(405) 546-4130
Entity
Organization
Contact information
Practice address
1001 N KENNEDY AVE, SHAWNEE, OK 74801-4730
(405) 273-3084
Mailing address
3112 COOKE WAY, OKLAHOMA CITY, OK 73179-2401
(405) 600-6869
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
07/23/2018
Last updated
06/22/2021
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