Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | Hwy 39 & Yy, Shell Knob, Missouri |
Authorized Official Name and Position | David P Taylor (VICE PRESIDENT) |
Authorized Official Contact | 4172696262 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 4046 Springfield MO 65808-4046 Ph: (417) 269-7834 | Hwy 39 & Yy Shell Knob MO 65747 Ph: (417) 269-2470 |
NPI Number | 1750456281 |
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Provider Enumeration Date | 11/21/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1750456281 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |