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120 W 16th St Mountain Grove MO 65711-1039 | |
(417) 926-6111 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 120 W 16th St, Mountain Grove, Missouri |
Authorized Official Name and Position | Scott Reynolds (VP-FINANCE) |
Authorized Official Contact | 4178202818 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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120 W 16th St Mountain Grove MO 65711-1039 Ph: (417) 926-6111 | 120 W 16th St Mountain Grove MO 65711-1039 Ph: (417) 926-6111 |
NPI Number | 1639517832 |
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Provider Enumeration Date | 06/10/2013 |
Last Update Date | 06/10/2013 |
Identifier | Type | State | Issuer |
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1639517832 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Mountain Grove Medical And Laser Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 601 N Busch Ave, Mountain Grove, MO 65711 Phone: 417-926-6643 Fax: 417-926-6317 | |