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General NPI Number Information
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NPI Number | 1265859177
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Entity Type | Organization
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Legal Business Name | XPRESS WELLNESS, LLC
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Dates
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Enumeration Date | 03/28/2014
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Last Update Date | 03/28/2014
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Provider Practice Location Address
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Address Line | 411 W 3RD ST
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City | ELK CITY
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State | OK
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Zip | 73644-5201
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Country | US
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Telephone | 580-303-9293
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Fax |
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Provider Business Mailing Address
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Address Line | 1710 W WILLOW RD SUITE 200
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City | ENID
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State | OK
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Zip | 73703-2438
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Country | US
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Telephone | 580-234-3971
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. BRIAN HAYDEN
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Credential |
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Telephone | 580-234-3971
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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