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Organization

ST. LOUIS JC VAMC

Active
Other names
HEARTLAND STREET VA CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
ERIN D POTTER (NPI TEAM MEMBER)
(202) 382-2579
Entity
Organization

Contact information

Practice address
3403 HEARTLAND STREET, MARION, IL 62959-6393
(913) 578-4409
Mailing address
PO BOX 94462, CLEVELAND, OH 44101-4462
(913) 578-4409

Taxonomy

Speciality
Code
Description
License number
State
261QV0200X
VA Clinic/Center
Primary

Other

Enumeration date
01/26/2015
Last updated
01/17/2018
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