Organization
PILOT GROVE RURAL HEALTH CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMY D LEDBETTER (DIRECTOR OF OPERATIONS)
(573) 651-4488
Entity
Organization
Contact information
Practice address
212 COLLEGE ST, PILOT GROVE, MO 65276-1005
(660) 834-5100
(660) 834-5101
Mailing address
212 COLLEGE ST, PILOT GROVE, MO 65276-1005
(660) 834-5100
(660) 834-5101
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507476406
—
MO
Enumeration date
04/23/2008
Last updated
04/23/2008
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