| Forever Young | |
|
6055 N Main Street Rd Webb City MO 64870-7219 | |
| (417) 206-0900 | |
| (417) 206-0907 |
| Full Name | Forever Young |
|---|---|
| Speciality | Clinic/center |
| Location | 6055 N Main Street Rd, Webb City, Missouri |
| Authorized Official Name and Position | David Larue (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4172060900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Forever Young 6031 N Main Street Rd #395 Webb City MO 64870-7219 Ph: (417) 206-0900 | Forever Young 6055 N Main Street Rd Webb City MO 64870-7219 Ph: (417) 206-0900 |
| NPI Number | 1619333481 |
|---|---|
| Provider Enumeration Date | 01/11/2016 |
| Last Update Date | 01/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619333481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | R9J48 (Missouri) | Primary |
Hamlin Medical Innovations Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1001 W Daugherty St, Webb City, MO 64870 Phone: 417-717-2017 Fax: 417-717-2134 |