Organization
ADVANCED WEIGHT LOSS CLINIC, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRITTANY HALEY (PROFFESSIONAL)
(417) 743-5113
Entity
Organization
Contact information
Practice address
6809 STATE HIGHWAY 14 W, CLEVER, MO 65631-6799
(417) 743-5113
(417) 743-5113
Mailing address
6809 SOUTH STATE HWY 14, CLEVER, MO 65631
(417) 743-5113
(417) 743-5113
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
01/18/2013
Last updated
01/18/2013
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