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Organization

PHYSICIAN GROUPS LC

Active
Other names
Centralia Family Health Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
KAREN CANTER-KOESTER (VICE PRESIDENT/AUTHORIZED OFFICIAL)
(314) 996-7610
Entity
Organization

Contact information

Practice address
1021 E HIGHWAY 22, CENTRALIA, MO 65240-1183
(573) 682-5580
(573) 682-1539
Mailing address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-6245

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
261QR1300X
Rural Health Clinic/Center
Primary

Other

Enumeration date
08/21/2007
Last updated
09/28/2021
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