Organization
VIENNA FAMILY PRACTICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH EDWARD SEGALL DO (SOLE MEMBER)
(573) 422-3360
Entity
Organization
Contact information
Practice address
111 PARKWAY, VIENNA, MO 65582-8003
(573) 422-3360
(573) 422-3391
Mailing address
111 PARKWAY, VIENNA, MO 65582-8003
(573) 422-3360
(573) 422-3391
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/24/2011
Last updated
08/24/2011
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