Organization
NORTHEAST MISSOURI HEALTH COUNCIL, INC.
Active
Other names
Kirksville Veterans Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW H GRIMM (EXECUTIVE DIRECTOR)
(660) 627-5757
Entity
Organization
Contact information
Practice address
1510 CROWN DRIVE, KIRKSVILLE, MO 63501-4002
(660) 627-8387
(660) 627-0878
Mailing address
1416 CROWN DRIVE, KIRKSVILLE, MO 63501-0000
(660) 627-5757
(660) 627-5802
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
2203032101
MO
207Q00000X
Family Medicine Physician
Primary
R5C53
MO
363L00000X
Nurse Practitioner
104748
MO
363LF0000X
Family Nurse Practitioner
2010018560
MO
Other
Enumeration date
12/11/2007
Last updated
01/24/2011
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