# PCRMC MEDICAL GROUP, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PCRMC Medical Group Rieth
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508056540
- **Authorized official:** JOHN DENBO (CEO)
- **Authorized official phone:** (573) 458-8899

## Contact information

- **Practice address:** 1050 W 10TH ST, ROLLA, MO 65401-2905
- **Practice address phone:** (573) 458-3431
- **Practice address fax:** (573) 458-3433
- **Mailing address:** PO BOX 579, ROLLA, MO 65402-0579
- **Mailing address phone:** (314) 989-0300

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/26/2007
- **Last updated:** 05/01/2023