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Organization
COMMUNITY CLINIC OF SOUTHWEST MISSOURI
Active
Organization
COMMUNITY CLINIC OF SOUTHWEST MISSOURI
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE MARIE BRADY (EXECUTIVE DIRECTOR)
(417) 624-5500
Entity
Organization
Contact information
Practice address
701 S JOPLIN AVE, JOPLIN, MO 64801-4515
(417) 624-5500
Mailing address
701 S JOPLIN AVE, JOPLIN, MO 64801-4515
(417) 624-5500
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
08/29/2023
Last updated
08/29/2023
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