Organization
ST JOHNS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DONN E. SORENSEN (SENIOR VICE PRESIDENT/COO)
(417) 829-4264
Entity
Organization
Contact information
Practice address
613 ORCHARD DR, BERRYVILLE, AR 72616-5013
(870) 423-4240
(870) 423-4241
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
M00127
AR
Other
Enumeration date
10/24/2007
Last updated
06/30/2008
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