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Organization
PUTNAM COUNTY MEDICAL HOME CLINICS, LLC
Active
Organization
PUTNAM COUNTY MEDICAL HOME CLINICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN FAIRLEY (SOLE OWNER)
(610) 737-4704
Entity
Organization
Contact information
Practice address
103 S 18TH ST, UNIONVILLE, MO 63565-1642
(660) 947-2300
(660) 947-2307
Mailing address
2221 GREEN ST, UNIONVILLE, MO 63565-1426
(610) 737-4704
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/24/2016
Last updated
10/24/2016
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