Organization
MONTGOMERY COUNTY COMMUNITY CLINIC, INC
Active
Other names
First Presbyterian Church dba Montgomery County Community Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN V.M. KLEINBECK RN, PHD (EXECUTIVE DIRECTOR)
(620) 331-8190
Entity
Organization
Contact information
Practice address
900 W MYRTLE ST, SUITE 105, INDEPENDENCE, KS 67301-3242
(620) 331-8190
(620) 652-4143
Mailing address
PO BOX 612, INDEPENDENCE, KS 67301-0612
(620) 331-8190
(620) 652-4143
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
NONE REQUIRED
KS
Other
Enumeration date
06/25/2008
Last updated
06/25/2008
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