Organization
MEDIC ONE GATEWAY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RYAN K. KIBLER (PRESIDENT)
(870) 931-8562
Entity
Organization
Contact information
Practice address
1530 FAIRVIEW AVE, ST. LOUIS, MO 63132
(314) 339-3930
Mailing address
6007 DALTON FARMER DR., JONESBORO, AR 72404
(870) 972-8484
(870) 336-6227
Taxonomy
Speciality
Code
Description
License number
State
3416L0300X
Land Ambulance
Primary
—
—
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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