# FOREVER YOUNG

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** PROFESSIONAL URGENT CARE, LLC
- **Other names:** Professional Urgent Care, LLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1619333481
- **Legal business name:** PROFESSIONAL URGENT CARE, LLC
- **Authorized official:** DR. DAVID LARUE DO (MEDICAL DIRECTOR)
- **Authorized official phone:** (417) 206-0900

## Contact information

- **Practice address:** 6055 N MAIN STREET RD, WEBB CITY, MO 64870-7219
- **Practice address phone:** (417) 206-0900
- **Practice address fax:** (417) 206-0907
- **Mailing address:** 6031 N MAIN STREET RD, \#395, WEBB CITY, MO 64870-7219
- **Mailing address phone:** (417) 206-0900
- **Mailing address fax:** (417) 206-0907

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | R9J48 | MO | Yes |

## Other

- **Enumeration date:** 01/11/2016
- **Last updated:** 01/11/2016