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Organization

BURTON CREEK RURAL CLINIC, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. THERESA CHRISTINE GREGG MHA (ADMINISTRATOR)
(417) 256-2111
Entity
Organization

Contact information

Practice address
909 N KENTUCKY AVE, WEST PLAINS, MO 65775-2024
(417) 257-6762
Mailing address
805 N KENTUCKY AVE, WEST PLAINS, MO 65775-2022
(417) 256-2111
(417) 256-4858

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2008008964
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2008008964
MO LICENSE
MO
Enumeration date
02/08/2011
Last updated
02/05/2026
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