| |
709 E Pine St Archie MO 64725-9215 | |
(816) 430-5777 | |
(816) 430-5219 |
Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 709 E Pine St, Archie, Missouri |
Authorized Official Name and Position | John Christopher Lang (CEO) |
Authorized Official Contact | 8163805888 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
709 E Pine St Archie MO 64725-9215 Ph: (816) 430-5777 | 709 E Pine St Archie MO 64725-9215 Ph: (816) 430-5777 |
NPI Number | 1962647115 |
---|---|
Provider Enumeration Date | 12/02/2008 |
Last Update Date | 12/02/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962647115 | NPI | - | NPPES |
20663016 | Other | MO | BCBS OF KC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |