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General NPI Number Information
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NPI Number | 1740615426
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Entity Type | Organization
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Legal Business Name | A PLUS MINOR EMERGENCY WALK IN CLINIC
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 12/26/2014
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Provider Practice Location Address
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Address Line | 916 N MAIN ST
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City | ALTUS
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State | OK
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Zip | 73521-3118
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Country | US
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Telephone | 580-480-0033
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Fax | 580-480-0044
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Provider Business Mailing Address
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Address Line | 916 N MAIN
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City | ALTUS
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State | OK
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Zip | 73521-3118
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Country | US
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Telephone | 580-480-0033
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Fax | 580-480-0044
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. ANTHONY QUINN NEAL
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Credential |
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Telephone | 580-318-0307
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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 | OK3838
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License Number State | OK
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