Individual
MR. AUSTIN BOONE MCCLURE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-1078
(417) 347-1079
Mailing address
1102 W 32ND ST, JOPLIN, MO 64804-3503
(417) 347-1078
(417) 347-1079
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2008020244
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2014017971
MO
Other
Enumeration date
06/11/2014
Last updated
07/02/2014
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