Organization
CREATIVE ENTERPRISES OF CLARENCE
Active
Other names
Carol Timmons Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN D TIMMONS (OWNER)
(660) 651-6961
Entity
Organization
Contact information
Practice address
101 N CENTER ST, CLARENCE, MO 63437-1701
(660) 699-2240
Mailing address
210 S SHELBY ST, CLARENCE, MO 63437-2105
(660) 651-6961
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
092882
MO
363LF0000X
Family Nurse Practitioner
092882
MO
363LG0600X
Gerontology Nurse Practitioner
092882
MO
Other
Enumeration date
02/16/2010
Last updated
12/19/2012
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