Organization
INTEGRATED CARE PROFESSIONALS OF MISSOURI, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RODNEY THOMASON (AUTHORIZED OFFICIAL)
(501) 406-6180
Entity
Organization
Contact information
Practice address
4625 LINDELL BLVD STE 214, SAINT LOUIS, MO 63108-3725
(601) 258-7154
Mailing address
PO BOX 3457, LITTLE ROCK, AR 72203-3457
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/10/2020
Last updated
01/10/2020
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