Organization
ADVANCED MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREG JOHNSON (CEO)
(573) 442-1788
Entity
Organization
Contact information
Practice address
311 N KEENE ST, COLUMBIA, MO 65201-6623
(573) 442-1788
(573) 442-1789
Mailing address
311 N KEENE ST, COLUMBIA, MO 65201-6623
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Enumeration date
09/05/2013
Last updated
09/05/2013
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