Organization
ST. JOHN'S HEALTH SYSTEM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER L CODUTTI (ATHLETIC TRAINER)
(417) 820-5010
Entity
Organization
Contact information
Practice address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5010
Mailing address
4331 S FREMONT AVE, SPRINGFIELD, MO 65804-7328
(417) 820-5010
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
2006026947
MO
Other
Enumeration date
08/24/2010
Last updated
08/24/2010
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