Organization
PCASC, LLC
Active
Other names
Surgery Center of the Northland
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE PETERSON MD (MEMBER)
(816) 232-1049
Entity
Organization
Contact information
Practice address
1101 KENTUCKY AVENUE, PLATTE CITY, MO 64079
(816) 232-1049
Mailing address
1101 KENTUCKY AVENUE, PLATTE CITY, MO 64079
(816) 232-1049
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
07/29/2025
Last updated
08/20/2025
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