Organization
RADIANCE HEALTH GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKSON PRESTON III (OWNER)
(573) 401-1650
Entity
Organization
Contact information
Practice address
104 N SPRIGG ST, CAPE GIRARDEAU, MO 63701-5528
(573) 401-1650
Mailing address
104 N SPRIGG ST, CAPE GIRARDEAU, MO 63701-5528
(573) 401-1650
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/09/2018
Last updated
07/09/2018
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