Organization
PHELPS COUNTY REGIONAL MEDICAL CENTER
Active
Parent organization
PHELPS COUNTY REGIONAL MEDICAL CENTER
Other names
Judith Cain
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHELPS COUNTY REGIONAL MEDICAL CENTER
Authorized official
MRS. KATHERINE R. HUNTER LPN (CLINIC COORDINATOR)
(573) 364-2007
Entity
Organization
Contact information
Practice address
1206 HOMELIFE DR., ROLLA, MO 65401
(357) 364-2007
(573) 364-8695
Mailing address
1206 HOMELIFE DR., ROLLA, MO 65401
(357) 364-2007
(573) 364-8695
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20020110
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20020110
MO STATE
MO
05
—
499035616
—
MO
Enumeration date
09/13/2006
Last updated
07/15/2008
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