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Organization

A PLUS FAMILY CLINIC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. AMY D LEDBETTER (DIRECTOR OF OPERATIONS)
(573) 651-4488
Entity
Organization

Contact information

Practice address
203 E 3RD ST, PORTAGEVILLE, MO 63873-1401
(573) 379-2100
(573) 379-2101
Mailing address
203 E 3RD ST, PORTAGEVILLE, MO 63873-1401
(573) 379-2100
(573) 379-2101

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
507603900
MO
Enumeration date
04/23/2008
Last updated
04/23/2008
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