Organization
COVENANT OPTIMIZED LIVING LLC
Active
Organization
COVENANT OPTIMIZED LIVING LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KARI J HAYWOOD (BILLING MANAGER)
(816) 233-3700
Entity
Organization
Contact information
Practice address
4910 FREDERICK AVE, SAINT JOSEPH, MO 64506-3246
(816) 233-3700
(816) 233-3754
Mailing address
4910 FREDERICK AVE, SAINT JOSEPH, MO 64506-3246
(816) 233-3700
(816) 233-3754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
112571
MO
Other
Enumeration date
03/26/2012
Last updated
03/26/2012
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