Organization
KNEIBERT CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOM R WARNER (ASST ADMINISTRATOR)
(573) 778-7175
Entity
Organization
Contact information
Practice address
686 LESTER ST, POPLAR BLUFF, MO 63901-5025
(573) 686-2411
Mailing address
686 LESTER ST, POPLAR BLUFF, MO 63901-5025
(573) 686-2411
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161274722
—
AR
Enumeration date
10/21/2008
Last updated
10/21/2008
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