Organization
HOMETOWN HEALTHCARE OF DESOTO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA F AMES-POWERS FNP-BC (OWNER)
(636) 337-5522
Entity
Organization
Contact information
Practice address
106 EASTON ST, DE SOTO, MO 63020-1706
(636) 337-5522
(636) 337-5525
Mailing address
106 EASTON ST, DE SOTO, MO 63020-1706
(636) 337-5522
(636) 337-5525
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
126672
MO
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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