| Kybama, Inc | |
|
12729 Stoney Point Rd Bonne Terre MO 63628-5500 | |
| (573) 631-2897 | |
| (573) 358-8727 |
| Full Name | Kybama, Inc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 12729 Stoney Point Rd, Bonne Terre, Missouri |
| Authorized Official Name and Position | Lennie Michael Fincher (PRESIDENT) |
| Authorized Official Contact | 5736312897 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kybama, Inc Po Box 71 Potosi MO 63664-0071 Ph: (573) 358-8703 | Kybama, Inc 12729 Stoney Point Rd Bonne Terre MO 63628-5500 Ph: (573) 631-2897 |
| NPI Number | 1699486506 |
|---|---|
| Provider Enumeration Date | 12/12/2022 |
| Last Update Date | 12/12/2022 |
| Certification Date | 11/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699486506 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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