Organization
GREAT MINES HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DONNA L BLOUNT (OFFICE MANAGER)
(573) 438-9355
Entity
Organization
Contact information
Practice address
123 W PRATT ST, DE SOTO, MO 63020-2107
(636) 586-2522
(636) 586-2546
Mailing address
123 W PRATT ST, DE SOTO, MO 63020-2107
(636) 586-2522
(636) 586-2546
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/03/2007
Last updated
02/04/2008
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