Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2019-04-26
- Last updated
- 2019-04-26
Licenses
The registry row did not include a license.
Location
- Practice location
- 1500 W ASHLAND ST
- City
- NEVADA MO
- Postal code
- 647721710
- Phone
- 800-654-9605
Organization contact
- Name
- ELIZABETH CURTIS
- Title
- Director of Business Development
- Phone
- 4174485627
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.