| Full Name | |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 910 W 10th St, Rolla, Missouri |
| Authorized Official Name and Position | Cheryl B Schrader (CHANCELLOR) |
| Authorized Official Contact | 5733414116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
910 W 10th St Rolla MO 65409-0760 Ph: (573) 341-4284 | 910 W 10th St Rolla MO 65409-0760 Ph: (573) 341-4284 |
| NPI Number | 1790051050 |
|---|---|
| Provider Enumeration Date | 03/30/2012 |
| Last Update Date | 03/30/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790051050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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