Mid-south Health Clinic Llc

NPI 1073595096 - Clinic/Center - 261QR1300X

NPI Details
NPI 1073595096
Enumeration Date 11/16/2005
Last Updated 07/10/2008
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name JOETTA JOETTA
Position ADMINISTRATOR
Phone (573) 785-0851
Fax
Practice Location
3100 WARRIOR LN
POPLAR BLUFF MO, 63901-8686, US
Phone (573) 785-0851
Fax
Business Location
233 E CENTER DR
ALTON IL, 62002-5931, US
Phone (618) 465-7717
Fax (618) 465-7710
Toxanomy
Taxonomy Code 261QR1300X
License State Missouri
License Number 031640
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According to our database, Mid-south Health Clinic Llc NPI is 1073595096, taxonomy code is 261QR1300X and license number is 031640, license state is located at Missouri. Mid-south Health Clinic Llc physically located at 3100 Warrior Ln, Poplar Bluff MO, 63901-8686. NPI Number 1033115704 has the healthcare provider type.

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1073595096 NPI number is provided on an as is basis without warranty of any kind. 1073595096 is maintained by the National Plan & Provider Enumeration System. The contents of Mid-south Health Clinic Llc are for informational purposes only.