Full Name | |
---|---|
Speciality | Clinic/center - Rural Health |
Location | 1805 Elm St, Canton, Missouri |
Authorized Official Name and Position | Maureen Kahn (PRESIDENT / CEO) |
Authorized Official Contact | 2172238400 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
1005 Broadway St Quincy IL 62301-2834 Ph: (217) 223-8400 | 1805 Elm St Canton MO 63435-1685 Ph: (573) 288-0616 |
NPI Number | 1093489098 |
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Provider Enumeration Date | 08/03/2021 |
Last Update Date | 07/11/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093489098 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |