Individual
MACK LEE CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3634 MARBLE HILL RD, POPLAR BLUFF, MO 63901-2228
(573) 718-0971
Mailing address
3634 MARBLE HILL RD, POPLAR BLUFF, MO 63901-2228
(573) 718-0971
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
03/10/2020
Last updated
03/10/2020
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