Organization
DEKALB COUNTY SENATE BILL 40
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RON CRIDER (CHAIRPERSON)
(816) 449-5481
Entity
Organization
Contact information
Practice address
113 EAST MAIN, MAYSVILLE, MO 64494
(816) 449-2200
Mailing address
PO BOX 514, MAYSVILLE, MO 64469-0514
(816) 449-2200
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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