Team Clinics Ah LLC
Clinic/Center, Primary Care in Broken Arrow, OK. Organization (NPI-2).
NPI number1164033452
StatusActive
Last updated in NPPESJun 21, 2021
Details
- NPI
- 1164033452
- Entity type
- Organization (NPI-2)
- Legal business name
- Team Clinics Ah LLC
- Organization subpart
- No
- Enumeration date
- Aug 11, 2020
- Certification date
- Jun 21, 2021
- Last updated
- Jun 21, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Practice location
2700 W Florence StBroken Arrow, OK 74011-1722
Phone 405-546-4130
Mailing address
3112 Cooke WayOklahoma City, OK 73179-2401
Phone 405-546-4130
Authorized official
Trevor Nutt
Ceo
4055464130
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