Organization
GRACE FAMILY MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH M KULPEKSA MD (OWNER)
(573) 922-5111
Entity
Organization
Contact information
Practice address
1206 WARD AVE, CARUTHERSVILLE, MO 63830-2204
(573) 922-5111
(573) 922-5126
Mailing address
1206 WARD AVE, CARUTHERSVILLE, MO 63830-2204
(573) 922-5111
(573) 922-5126
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
117451
MO
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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