Organization
KIRKSVILLE SPECIALTY CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID NEUENDORF (CEO)
(573) 886-8904
Entity
Organization
Contact information
Practice address
1108 E PATTERSON ST STE 10, KIRKSVILLE, MO 63501-4043
(660) 956-0487
(660) 956-0446
Mailing address
1108 E PATTERSON ST STE 10, KIRKSVILLE, MO 63501-4043
(660) 956-0487
(660) 956-0446
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
R6C73
MO
261QM2500X
Medical Specialty Clinic/Center
—
—
Other
Enumeration date
09/06/2018
Last updated
02/11/2020
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