| NPI | 1063081263 |
|---|---|
| Doing Business As | FCC PRIMARY CARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | TRACY ELLIS Cco 573-888-5925 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-06-22 |