Organization
PROFESSIONAL CLINICS, LLC
Active
Other names
Convenient Healthcare
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMELIA D LEDBETTER (DIRECTOR OF OPERATIONS)
(573) 335-4715
Entity
Organization
Contact information
Practice address
624 OLD SAINT MARYS RD, SUITE A, PERRYVILLE, MO 63775-1837
(573) 547-3232
(573) 547-3231
Mailing address
624 OLD SAINT MARYS RD, SUITE A, PERRYVILLE, MO 63775-1837
(573) 547-3232
(573) 547-3231
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QR1300X
Rural Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA1758
MEDICARE PART B
—
Enumeration date
05/10/2016
Last updated
05/10/2016
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