| Country Care Family Clinic, Llc | |
| 
					3 E Cleveland Ave Ellsinore MO 63937  | |
| (573) 429-6698 | |
| Not Available | 
| Full Name | Country Care Family Clinic, Llc | 
|---|---|
| Speciality | Clinic/center - Primary Care | 
| Location | 3 E Cleveland Ave, Ellsinore, Missouri | 
| Authorized Official Name and Position | Laura Victoria Nance (NURSE PRACTITIONER/ OFFICE MANAGER) | 
| Authorized Official Contact | 5734296698 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Country Care Family Clinic, Llc Po Box 446 Ellsinore MO 63937-0446 Ph: (573) 429-6698  | Country Care Family Clinic, Llc 3 E Cleveland Ave Ellsinore MO 63937 Ph: (573) 429-6698  | 
| NPI Number | 1306313051 | 
|---|---|
| Provider Enumeration Date | 10/31/2018 | 
| Last Update Date | 10/31/2018 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1306313051 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |