Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Grand Lake Medical and Wellness Corp

Organization Primary Care Clinic/Center · NPI 1336706118

Grand Lake Medical and Wellness Corp is a Primary Care Clinic/Center in Sallisaw, Oklahoma. Works from 2 locations. Registered with an NPI since 2019.

In the registry since
2019
Specialties on file
2
What do these letters mean?
Corp — Corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

101 W Quesenbury Ave
Sallisaw, OK 74955-3613
Phone: (918) 235-6877
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 302 N Greenwood Ave, Fort Smith, AR 72901-3454 — (479) 434-3600

Specialties & licences

Pain Clinic/Center (primary) Taxonomy 261QP3300X
Primary Care Clinic/Center Taxonomy 261QP2300X

Record details

NPI number1336706118
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Serena Wilson — Owner · (918) 961-1658
Other names Serena Wilson
NPI enumeratedMay 28, 2019
Last updated in NPPESMay 28, 2019
Mailing address58700 E 190 Rd, Fairland, OK 74343-2500

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