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1605 Martin Springs Dr Ste 210 Rolla MO 65401-3028 | |
| (573) 458-6350 | |
| (573) 458-6764 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 1605 Martin Springs Dr Ste 210, Rolla, Missouri |
| Authorized Official Name and Position | Robert Cavagnol (CHIEF PHYSICIAN OFFICER) |
| Authorized Official Contact | 4178202705 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
645 Maryville Centre Dr Fl 3 Saint Louis MO 63141-5855 Ph: (417) 820-7133 | 1605 Martin Springs Dr Ste 210 Rolla MO 65401-3028 Ph: (573) 458-6350 |
| NPI Number | 1811028723 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 12/04/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811028723 | NPI | - | NPPES |
| 595684804 | Medicaid | MO |
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