Full Name | |
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Speciality | Family Medicine |
Location | 100 W 4th St, Montrose, Missouri |
Authorized Official Name and Position | Delores B Bracher (BILLING CLERK) |
Authorized Official Contact | 6604762121 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 64 Montrose MO 64770-0064 Ph: (660) 693-8885 | 100 W 4th St Montrose MO 64724 Ph: (660) 693-8885 |
NPI Number | 1588801922 |
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Provider Enumeration Date | 01/07/2009 |
Last Update Date | 01/21/2009 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588801922 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |