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201 West High Street Suite 2 Willow Springs MO 65793 | |
(417) 252-6994 | |
(417) 469-0651 |
Full Name | |
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Speciality | Clinic/center |
Location | 201 West High Street, Willow Springs, Missouri |
Authorized Official Name and Position | Barrylyn Ulmanis (PROVIDER ENROLLMENT COORDINATOR) |
Authorized Official Contact | 4172576782 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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201 West High Street, Suite 2 Willow Springs MO 65793 Ph: (417) 252-6994 | 201 West High Street Suite 2 Willow Springs MO 65793 Ph: (417) 252-6994 |
NPI Number | 1124514476 |
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Provider Enumeration Date | 07/10/2018 |
Last Update Date | 11/19/2018 |
Identifier | Type | State | Issuer |
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1124514476 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Valley Medical Center P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 308 S Harris St, Willow Springs, MO 65793 Phone: 417-469-3175 Fax: 417-469-1274 | |