Organization
HANNIBAL REGIONAL HOSPITAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL JACO (SR. VICE PRESIDENT OF PATIENT CARE)
(573) 248-5257
Entity
Organization
Contact information
Practice address
188A MEDICAL DR, HANNIBAL, MO 63401-6877
(573) 406-0576
Mailing address
4537 W ELY RD, #804, HANNIBAL, MO 63401-2546
(573) 248-3889
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2002030211
MO
Other
Enumeration date
04/05/2006
Last updated
08/22/2020
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