Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2007-03-05
- Last updated
- 2024-03-08
Specialties
Licenses
The registry row did not include a license.
Location
- Practice location
- 3216 S NATIONAL AVE
- City
- SPRINGFIELD MO
- Postal code
- 65807
- Phone
- 417-886-0404
Organization contact
- Name
- MAGGIE ROLLWAGEN
- Title
- President
- Phone
- 4178860404
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.