Organization
BENNETT CLINIC, PC
Active
Organization
BENNETT CLINIC, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALLISON B. BENNETT A.R.N.P. (OWNER/FAMILY NURSE PRACTITIONER)
(580) 625-2273
Entity
Organization
Contact information
Practice address
623 AVENUE C, BEAVER, OK 73932-3126
(580) 625-2273
(580) 625-2274
Mailing address
PO BOX 964, BEAVER, OK 73932-0964
(580) 625-2273
(580) 625-2274
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
R0071654
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200317900A
—
OK
Enumeration date
12/17/2010
Last updated
04/05/2011
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