Organization
J & M ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RICKETTS CRNA (MBR)
(573) 686-5550
Entity
Organization
Contact information
Practice address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 686-5550
Mailing address
209 S MAIN ST, POPLAR BLUFF, MO 63901-5831
(573) 686-5550
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
MO
Other
Enumeration date
06/13/2012
Last updated
06/13/2012
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