Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-03-08
- Last updated
- 2020-08-22
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 1207 PARRY ST
- City
- LAMAR MO
- Postal code
- 647592163
- Phone
- 417-682-3825
Organization contact
- Name
- JOEL WOLVERTON
- Title
- President
- Phone
- 4176823825
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.