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Organization
CHILLICOTHE WOMENS CLINIC LLC
Active
Organization
CHILLICOTHE WOMENS CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YULIA PENISTON DO (PHYSICIAN)
(913) 680-9830
Entity
Organization
Contact information
Practice address
861 FAIRWAY DR, CHILLICOTHE, MO 64601-3673
(913) 680-9830
Mailing address
4566 STATE HIGHWAY 190, CHILLICOTHE, MO 64601-5313
(913) 680-9830
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
NULL
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VG0400X
Gynecology Physician
—
NULL
207VG0400X
Gynecology Physician
—
—
Other
Enumeration date
01/24/2022
Last updated
05/17/2022
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