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General NPI Number Information
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NPI Number | 1538475561
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Entity Type | Organization
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Legal Business Name | DRUMRIGHT HEALTH AND URGENT CARE CLINIC, LLC
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Dates
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Enumeration Date | 08/27/2010
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Last Update Date | 04/11/2011
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Provider Practice Location Address
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Address Line | 505 W 2ND STREET
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City | DRUMRIGHT
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State | OK
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Zip | 74030
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Country | US
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Telephone | 918-352-9565
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Fax | 918-352-2180
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Provider Business Mailing Address
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Address Line | 505 W 2ND STREET
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City | DRUMRIGHT
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State | OK
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Zip | 74030
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Country | US
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Telephone | 918-352-9565
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Fax | 918-352-2180
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Authorized Official
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Title or Position | MANAGER
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Name | TRACY WOHLGEMUTH
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Credential |
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Telephone | 918-352-9565
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 20075
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License Number State | OK
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