Organization
ALLERGY AND ASTHMA CONSULTANTS OF THE OZARK,LTD
Active
Organization
ALLERGY AND ASTHMA CONSULTANTS OF THE OZARK,LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LEWIS VANDEWALKER M.D. (PHYSICIAN)
(573) 634-7000
Entity
Organization
Contact information
Practice address
1233 JEFFERSON ST, JEFFERSON CITY, MO 65109-2469
(573) 634-7000
Mailing address
1233 JEFFERSON ST, JEFFERSON CITY, MO 65109-2469
(573) 634-7000
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
R2F17
MO
Other
Enumeration date
08/30/2006
Last updated
10/03/2007
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