Organization
KENNETT HMA LLC
Active
Other names
Twin Rivers Medical Group-IM
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA M LALOR (DIRECTOR/DELEGATED OFFICIAL)
(615) 925-4565
Entity
Organization
Contact information
Practice address
1231 1ST ST, KENNETT, MO 63857-2527
(573) 888-8606
(573) 717-1085
Mailing address
1231 1ST ST, KENNETT, MO 63857-2527
(573) 888-8606
(573) 717-1085
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
5147
MO
Other
Enumeration date
10/17/2016
Last updated
10/09/2017
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