| NPI | 1215510490 |
|---|---|
| Doing Business As | FCC PRIMARY CARE CLINIC POPLAR BLUFF |
| Entity Type | Organization |
| Authorized Contact | TRACY ELLIS Cco 573-888-5925 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-05-04 |
| Last Update Date | 2021-07-12 |