Organization
DALE FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY D LEDBETTER (DIRECTOR OF OPERATIONS)
(573) 651-4488
Entity
Organization
Contact information
Practice address
1340 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2045
(417) 967-3755
(417) 967-2630
Mailing address
1340 S SAM HOUSTON BLVD, HOUSTON, MO 65483-2045
(417) 967-3755
(417) 967-2630
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
503362600
—
MO
Enumeration date
04/23/2008
Last updated
04/23/2008
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