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605 Douglas Dr # C Ashland MO 65010-9088 | |
(573) 882-2215 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 605 Douglas Dr # C, Ashland, Missouri |
Authorized Official Name and Position | Herert L Stanley (ASSOCIATE DIRECTOR FINANCE) |
Authorized Official Contact | 5738821095 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 7687 Columbia MO 65205-7687 Ph: (573) 882-8612 | 605 Douglas Dr # C Ashland MO 65010-9088 Ph: (573) 882-2215 |
NPI Number | 1417042458 |
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Provider Enumeration Date | 10/04/2006 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1417042458 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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