Organization
COUNTRY CARE CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIFFANY GREEN (OWNER)
(405) 356-3001
Entity
Organization
Contact information
Practice address
309 W 2ND ST STE B, WELLSTON, OK 74881-9496
(405) 356-3001
(405) 832-1144
Mailing address
PO BOX 304, WELLSTON, OK 74881-0304
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
02/06/2020
Last updated
02/06/2020
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