Individual
CLAY OWEN THORNBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
100 MEDICAL DR, HANNIBAL, MO 63401-6877
(573) 221-5250
(573) 231-3713
Mailing address
602 S HOME ST, PALMYRA, MO 63461-1747
(573) 822-8530
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2020023348
MO
Other
Enumeration date
07/28/2020
Last updated
07/25/2022
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