Organization
ST JOHNS CLINIC INC
Active
Other names
SJC-Ava
Organization subpart
No
Provider details
NPI number
Authorized official
DONN E. SORENSEN (SENIOR VICE PRESIDENT)
(417) 829-4620
Entity
Organization
Contact information
Practice address
1312 NORTH HIGHWAY 5, AVA, MO 65608
(417) 683-4045
(417) 683-6069
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
MO
Other
Enumeration date
04/16/2007
Last updated
06/30/2008
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