Blackhawk Mangum LLC

NPI #1295069151 in Mangum, Oklahoma

Provider Information

NPI Number
1295069151
Entity Type
Organization
Organization Name
Blackhawk Mangum LLC
Primary Specialty
Clinic/Center - Rural Health
Enumeration Date
Sep 25, 2009
Last Updated
Sep 25, 2009

Practice Location

Address
118 S LOUIS TITTLE AVE
City
Mangum
ZIP Code
73554-4441
Phone
(580) 782-3353

Authorized Official

Name
JAN WINTER
Title
CEO
Phone
(580) 782-3353

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Rural HealthRural Health

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