Organization
GRACE WEEKEND CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEA DENISE CAMPBELL D.O. (OWNER/OPERATOR)
(660) 646-3400
Entity
Organization
Contact information
Practice address
417 PARK LN, CHILLICOTHE, MO 64601-1550
(660) 646-3400
(660) 646-3410
Mailing address
417 PARK LN, CHILLICOTHE, MO 64601-1550
(660) 646-3400
(660) 646-3410
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
108529
MO
Other
Enumeration date
10/09/2006
Last updated
08/09/2007
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