Provider Demographics
NPI:1265859177
Name:XPRESS WELLNESS, LLC
Entity Type:Organization
Organization Name:XPRESS WELLNESS, LLC
Other - Org Name:XPRESS WELLNESS URGENT CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-234-3971
Mailing Address - Street 1:1710 W WILLOW RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ENID
Mailing Address - State:OK
Mailing Address - Zip Code:73703-2438
Mailing Address - Country:US
Mailing Address - Phone:580-234-3971
Mailing Address - Fax:
Practice Address - Street 1:411 W 3RD ST
Practice Address - Street 2:
Practice Address - City:ELK CITY
Practice Address - State:OK
Practice Address - Zip Code:73644-5201
Practice Address - Country:US
Practice Address - Phone:580-303-9293
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-28
Last Update Date:2014-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care