| Burton Creek Rural Clinic, Llc | |
|
909 N Kentucky Ave West Plains MO 65775-2024 | |
| (417) 257-6762 | |
| Not Available |
| Full Name | Burton Creek Rural Clinic, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 909 N Kentucky Ave, West Plains, Missouri |
| Authorized Official Name and Position | Sonja L Stauffer (ADMINISTRATOR) |
| Authorized Official Contact | 4172562111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Burton Creek Rural Clinic, Llc 805 N Kentucky Ave West Plains MO 65775-2022 Ph: (417) 256-2111 | Burton Creek Rural Clinic, Llc 909 N Kentucky Ave West Plains MO 65775-2024 Ph: (417) 257-6762 |
| NPI Number | 1679879704 |
|---|---|
| Provider Enumeration Date | 02/08/2011 |
| Last Update Date | 01/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679879704 | NPI | - | NPPES |
| 2008008964 | Other | MO | MO LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 2008008964 (Missouri) | Primary |
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