Individual
DR. PAUL DE VRIES RAINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
350 E WALNUT ST, ELLINGTON, MO 63638-7943
(573) 663-2571
(573) 663-2779
Mailing address
350 E WALNUT ST, ELLINGTON, MO 63638-7943
(573) 663-2571
(573) 663-2779
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R3M48
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
597719509
—
MO
Enumeration date
05/24/2005
Last updated
10/03/2011
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