Organization
ST JOHNS CLINIC INC
Active
Other names
SJC-Family Medicine-South Creek
Organization subpart
No
Provider details
NPI number
Authorized official
DONN E. SORENSEN (SENIOR VICE PRESIDENT)
(417) 829-4264
Entity
Organization
Contact information
Practice address
2711 S MEADOWBROOK AVE, SPRINGFIELD, MO 65807-5924
(417) 887-0081
(417) 227-1412
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
06/28/2007
Last updated
06/30/2008
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