Provider Demographics
NPI:1679849798
Name:THERAPEUTIC HEALTH & WELLNESS LLC
Entity Type:Organization
Organization Name:THERAPEUTIC HEALTH & WELLNESS LLC
Other - Org Name:MORRISON RURAL HEALTH CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUFFINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:580-724-3600
Mailing Address - Street 1:506 W HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:OK
Mailing Address - Zip Code:73061-9593
Mailing Address - Country:US
Mailing Address - Phone:580-724-3600
Mailing Address - Fax:580-724-3601
Practice Address - Street 1:506 W HIGHWAY 64
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:OK
Practice Address - Zip Code:73061-9593
Practice Address - Country:US
Practice Address - Phone:580-724-3600
Practice Address - Fax:580-724-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-23
Last Update Date:2012-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK763363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedicalGroup - Single Specialty