Individual
GREG LINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3817 S SPRINGFIELD AVE, SUITE 140, BOLIVAR, MO 65613-9129
(417) 422-4769
(309) 284-2244
Mailing address
3817 S SPRINGFIELD AVE, SUITE 140, BOLIVAR, MO 65613-9129
(417) 422-4769
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036-096023
IL
207Q00000X
Family Medicine Physician
Primary
2019036152
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036096023
—
IL
01
—
809840
809840 GROUP FOR PEORIA
IL
Enumeration date
09/21/2006
Last updated
09/26/2019
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