Organization
ESSENTIAL FAMILY HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHELLY GRESHAM RN, APN (RN, APN, MEMBER)
(573) 714-6337
Entity
Organization
Contact information
Practice address
1369 NORTH WESTWOOD BLVD., POPLAR BLUFF, MO 63901
(573) 714-6337
Mailing address
1369 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-3313
(573) 714-6337
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
126637
MO
261QP2300X
Primary Care Clinic/Center
Primary
R9B65
MO
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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