Organization
ITS A WONDERFUL LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN ALLISON (ADMINISTRATOR)
(417) 239-0125
Entity
Organization
Contact information
Practice address
110 BUSINESS PARK DR STE C, BRANSON, MO 65616-7449
(417) 239-0125
(417) 239-0127
Mailing address
110 BUSINESS PARK DR STE C, BRANSON, MO 65616-7449
(417) 239-0125
(417) 239-0127
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2005019384
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
206293805
—
MO
Enumeration date
09/01/2017
Last updated
07/21/2022
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