| Ip Reserve | |
|
21332 Midway Ave Gallatin MO 64640-6314 | |
| (801) 639-9530 | |
| Not Available |
| Full Name | Ip Reserve |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 21332 Midway Ave, Gallatin, Missouri |
| Authorized Official Name and Position | Colin Forbes (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 8558221400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ip Reserve 21708 Nickel Ave Gallatin MO 64640-6369 Ph: () - | Ip Reserve 21332 Midway Ave Gallatin MO 64640-6314 Ph: (801) 639-9530 |
| NPI Number | 1649892779 |
|---|---|
| Provider Enumeration Date | 05/12/2020 |
| Last Update Date | 05/12/2020 |
| Certification Date | 05/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649892779 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |