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Organization
EXCELSIOR SPRINGS PHYSICIANS CLINIC
Active
Organization
EXCELSIOR SPRINGS PHYSICIANS CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER L BOOMGARDEN CRMA, BSHSA, EMBA (PHYSICIANS PRACTICE MANAGER)
(816) 629-2623
Entity
Organization
Contact information
Practice address
1700 RAINBOW BLVD, EXCELSIOR SPRINGS, MO 64024-1182
(816) 629-2623
(816) 629-2722
Mailing address
1010 N JESSE JAMES RD, EXCELSIOR SPRINGS, MO 64024-1202
(816) 630-6722
(816) 630-2471
Taxonomy
Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
Primary
R6J43
MO
Other
Enumeration date
02/04/2014
Last updated
02/04/2014
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