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Organization

TRI COUNTY MEDICAL CLINIC P C

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. ALAN M WEAVER D.O. (MEDICAL DIRECTOR)
(573) 687-3411
Entity
Organization

Contact information

Practice address
208 N OGDEN ST, BOX 367, STURGEON, MO 65284-9217
(573) 687-3411
(573) 687-3328
Mailing address
6601 W THORNHILL RD, CLARK, MO 65243-9381
(573) 687-3411
(573) 687-3328

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
R8G92
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
242429009
MO
Enumeration date
01/22/2009
Last updated
01/22/2009
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