Organization
MERCY CLINIC JOPLIN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STUART G STANGELAND (AUTHORIZED OFFICIAL)
(417) 820-3514
Entity
Organization
Contact information
Practice address
3126 S JACKSON AVE, STE 200, JOPLIN, MO 64804-2534
(417) 625-2278
(417) 625-2277
Mailing address
3126 S JACKSON AVE, STE 200, JOPLIN, MO 64804-2534
(417) 625-2278
(417) 625-2277
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215264817
—
MO
Enumeration date
03/12/2014
Last updated
03/21/2014
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