Organization
MISSOURI STATE UNIVERSITY
Active
Other names
The Kitchen Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARK BOWER M.D. (PHYSICIAN, MEDICAL DIRECTOR)
(417) 837-1500
Entity
Organization
Contact information
Practice address
1630 N JEFFERSON AVE, SPRINGFIELD, MO 65803-2819
(417) 837-1504
(417) 837-1545
Mailing address
MISSOURI STATE DEPARTMENT OF NURSING, 901 S. NATIONAL AVENUE, SPRINGFIELD, MO 65897-0001
(417) 836-5310
(417) 836-5484
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
2013003462
MO
Other
Enumeration date
02/20/2013
Last updated
02/20/2013
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