Evergreen Health Center, Pc

NPI 1306942693 - Psychologist - 103T00000X

NPI Details
NPI 1306942693
Enumeration Date 09/15/2006
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name AMY AMY
Position OFFICE MANAGER
Phone (417) 588-7923
Fax (417) 588-7924
Practice Location
1859 S JEFFERSON AVE
LEBANON MO, 65536-4221, US
Phone (417) 588-7923
Fax (417) 588-7924
Business Location
1859 S JEFFERSON AVE
LEBANON MO, 65536-4221, US
Phone (417) 588-7923
Fax (417) 588-7924
Toxanomy
Taxonomy Code 103T00000X
License State
License Number
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According to our database, Evergreen Health Center, Pc NPI is 1306942693, taxonomy code is 103T00000X Evergreen Health Center, Pc physically located at 1859 S Jefferson Ave, Lebanon MO, 65536-4221. NPI Number 1033115704 has the healthcare provider type.

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1306942693 NPI number is provided on an as is basis without warranty of any kind. 1306942693 is maintained by the National Plan & Provider Enumeration System. The contents of Evergreen Health Center, Pc are for informational purposes only.