Organization
DANCING HORIZON HEALTH LC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN W LOUDERBACK HHP (MANAGER)
(417) 429-2181
Entity
Organization
Contact information
Practice address
2400 BOONSLICK DRIVE, BOONVILLE, MO 65233
(660) 882-9840
(660) 882-3504
Mailing address
PO BOX 5111, SPRINGFIELD, MO 65801
(417) 429-2185
(417) 832-9799
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
R1F83
MO
Other
Enumeration date
12/05/2006
Last updated
10/22/2007
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