# ADVANCE MEDICAL CLINIC

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

## Provider details

- **NPI number:** 1265691869
- **Authorized official:** MS. LORI ANN WILLIAMS FNP-BC (OWNER)
- **Authorized official phone:** (573) 722-3467

## Contact information

- **Practice address:** 103 SOUTH OAK STREET, ADVANCE, MO 63730
- **Practice address phone:** (573) 722-3467
- **Practice address fax:** (573) 722-3469
- **Mailing address:** PO BOX 669, 103 SOUTH OAK STREET, ADVANCE, MO 63730-0669
- **Mailing address phone:** (573) 722-3467
- **Mailing address fax:** (573) 722-3469

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 06/09/2008
- **Last updated:** 05/24/2012