# HEARTLAND WEIGHT LOSS CLINIC, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215536818
- **Authorized official:** RYAN A LEGRAND MD (PHYSICIAN)
- **Authorized official phone:** (573) 803-2287

## Contact information

- **Practice address:** 3095 LEXINGTON AVE STE 200, CAPE GIRARDEAU, MO 63701-2629
- **Practice address phone:** (573) 803-2287
- **Mailing address:** 3095 LEXINGTON AVE STE 200, CAPE GIRARDEAU, MO 63701-2629
- **Mailing address phone:** (573) 803-2287

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 10/23/2020
- **Last updated:** 04/06/2023