| Willow Family Care | |
|
304 Teaco Rd Suite A Kennett MO 63857-3266 | |
| (573) 888-0303 | |
| (573) 888-0304 |
| Full Name | Willow Family Care |
|---|---|
| Speciality | Family Medicine |
| Location | 304 Teaco Rd, Kennett, Missouri |
| Authorized Official Name and Position | Amy D Ledbetter (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 5736514488 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Willow Family Care 304 Teaco Rd Suite A Kennett MO 63857-3266 Ph: (573) 888-0303 | Willow Family Care 304 Teaco Rd Suite A Kennett MO 63857-3266 Ph: (573) 888-0303 |
| NPI Number | 1841465689 |
|---|---|
| Provider Enumeration Date | 04/23/2008 |
| Last Update Date | 04/23/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841465689 | NPI | - | NPPES |
| 507016608 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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