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22361 Oak Ridge Dr Shell Knob MO 65747-7822 | |
(417) 858-3731 | |
(417) 858-2562 |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 22361 Oak Ridge Dr, Shell Knob, Missouri |
Authorized Official Name and Position | Stuart G. Stangeland (SENIOR VICE PRESIDENT, COO) |
Authorized Official Contact | 4178206556 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 505164 Saint Louis MO 63150-5164 Ph: (417) 820-2000 | 22361 Oak Ridge Dr Shell Knob MO 65747-7822 Ph: (417) 858-3731 |
NPI Number | 1104137876 |
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Provider Enumeration Date | 06/28/2010 |
Last Update Date | 04/28/2015 |
Identifier | Type | State | Issuer |
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1104137876 | NPI | - | NPPES |
1104137876 | Other | MO | RURAL HEALTH MEDICAID |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (Missouri) | Primary |