| NPI Details | |
|---|---|
| NPI | 1093844722 |
| Enumeration Date | 03/06/2007 |
| Last Updated | 07/08/2007 |
| Entity Type | Healthcare Provider |
| Active | Over 10 years ago |
| Authorized Information | |
|---|---|
| Name | MARTIN DALE MARTIN |
| Position | EXECUTIVE MANAGER |
| Phone | (660) 783-2464 |
| Fax | |
| Practice Location | |
|---|---|
| 308 SOUTH PROSPECT STANBERRY MO, 64489-0222, US |
|
| Phone | (660) 783-2464 |
| Fax | |
| Business Location | |
|---|---|
| PO BOX 222 401 SOUTH STANBERRY STREET STANBERRY MO, 64489-0222, US |
|
| Phone | (660) 783-2842 |
| Fax | |
| Toxanomy | |
|---|---|
| Taxonomy Code | 320600000X |
| License State | |
| License Number | |
| Remove 1093844722 NPI Number | |
According to our database, Northwest Missouri Supportive Services NPI is 1093844722, taxonomy code is 320600000X Northwest Missouri Supportive Services physically located at 308 South Prospect, Stanberry MO, 64489-0222. NPI Number 1033115704 has the healthcare provider type.
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1093844722 NPI number is provided on an as is basis without warranty of any kind. 1093844722 is maintained by the National Plan & Provider Enumeration System. The contents of Northwest Missouri Supportive Services are for informational purposes only.
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