Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2014-01-13
- Last updated
- 2014-01-13
Specialties
Licenses
- License MO
- 041597
Location
- Practice location
- 1495 E ASHLAND ST
- City
- NEVADA MO
- Postal code
- 647724016
- Phone
- 417-667-5000
Organization contact
- Name
- KAREN CLARK
- Title
- Managing Member
- Phone
- 4176675000
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.