Organization
ROADSIDE MEDICAL, LLC
Active
Other names
Roadside Medical Clinic and Lab
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHON WITHERSPOON (CHIEF EXECUTIVE OFFICER)
(941) 225-2520
Entity
Organization
Contact information
Practice address
699 STATE ROUTE 203, SUITE 1, EAST SAINT LOUIS, IL 62201-1608
(941) 225-2520
(888) 860-8609
Mailing address
8466 LOCKWOOD RIDGE RD, #248, SARASOTA, FL 34243-2951
(941) 225-2520
(888) 860-8609
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
08/03/2010
Last updated
08/03/2010
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