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751 Maple Valley Dr Suite C Farmington MO 63640-1944 | |
| (630) 653-1717 | |
| (630) 653-1025 |
| Full Name | |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 751 Maple Valley Dr, Farmington, Missouri |
| Authorized Official Name and Position | Heather Gandy (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6306531717 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2100 Manchester Rd Suite 1510 Wheaton IL 60187-4579 Ph: (630) 653-1717 | 751 Maple Valley Dr Suite C Farmington MO 63640-1944 Ph: (630) 653-1717 |
| NPI Number | 1326095134 |
|---|---|
| Provider Enumeration Date | 05/27/2006 |
| Last Update Date | 01/29/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326095134 | NPI | - | NPPES |
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