Organization
CANCER INSTITUTE OF CAPE GIRARDEAU, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE LUTTRELL ROCC (BILLER/CODER)
(573) 331-5916
Entity
Organization
Contact information
Practice address
14 DOCTORS PARK, SUITE B, CAPE GIRARDEAU, MO 63703-4928
(573) 334-2230
(573) 651-6499
Mailing address
14 DOCTORS PARK, SUITE B, CAPE GIRARDEAU, MO 63703-4928
(573) 334-2230
(573) 651-6499
Taxonomy
Speciality
Code
Description
License number
State
261QX0203X
Radiation Oncology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
514063
HEALTHLINK PROVIDER ID
MO
Enumeration date
11/03/2006
Last updated
08/22/2007
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