| Covenant Optimized Living LLC | |
|
4910 Frederick Ave Saint Joseph MO 64506-3246 | |
| (816) 233-3700 | |
| (816) 233-3754 |
| Full Name | Covenant Optimized Living LLC |
|---|---|
| Speciality | Internal Medicine |
| Location | 4910 Frederick Ave, Saint Joseph, Missouri |
| Authorized Official Name and Position | Kari J Haywood (BILLING MANAGER) |
| Authorized Official Contact | 8162333700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Covenant Optimized Living LLC 4910 Frederick Ave Saint Joseph MO 64506-3246 Ph: (816) 233-3700 | Covenant Optimized Living LLC 4910 Frederick Ave Saint Joseph MO 64506-3246 Ph: (816) 233-3700 |
| NPI Number | 1467728303 |
|---|---|
| Provider Enumeration Date | 03/26/2012 |
| Last Update Date | 03/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467728303 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 112571 (Missouri) | Primary |
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