Organization
IMAGE SPECIALTIES, L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA R MAXWELL RN, MSN, FNP (OWNER)
(816) 232-6459
Entity
Organization
Contact information
Practice address
5213 FREDERICK AVE, SAINT JOSEPH, MO 64506-3263
(816) 232-6459
(816) 232-6459
Mailing address
5213 FREDERICK AVE, SAINT JOSEPH, MO 64506-3263
(816) 232-6459
(816) 232-6459
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
096655
MO
Other
Enumeration date
08/01/2011
Last updated
08/24/2011
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