Organization
KIRKSVILLE ALLERGY AND ASTHMA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACY TALTON (CLINIC MANAGER)
(660) 627-2553
Entity
Organization
Contact information
Practice address
610 ROSEWOOD DR, KIRKSVILLE, MO 63501-2477
(660) 627-2553
(660) 665-0448
Mailing address
610 ROSEWOOD DR, KIRKSVILLE, MO 63501-2477
(660) 627-2553
(660) 665-0448
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
Primary
19139861
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500382205
—
MO
Enumeration date
03/11/2008
Last updated
10/01/2013
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