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1060 S Bishop Ave Rolla MO 65401-4411 | |
(573) 426-5900 | |
(573) 426-4466 |
Full Name | |
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Speciality | Internal Medicine |
Location | 1060 S Bishop Ave, Rolla, Missouri |
Authorized Official Name and Position | Oluyomi O Olusanya (OWNER/DEL. OFFICIAL) |
Authorized Official Contact | 5734265900 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 817 Cape Girardeau MO 63702-0817 Ph: (314) 989-0300 | 1060 S Bishop Ave Rolla MO 65401-4411 Ph: (573) 426-5900 |
NPI Number | 1881819464 |
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Provider Enumeration Date | 04/17/2007 |
Last Update Date | 09/14/2017 |
Identifier | Type | State | Issuer |
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1881819464 | NPI | - | NPPES |
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