| NPI | 1235738493 |
|---|---|
| Doing Business As | FCC PRIMARY CARE |
| Entity Type | Organization |
| Authorized Contact | TRACY S ELLIS Chief Compliance Officer 573-888-5925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-10-20 |
| Last Update Date | 2020-10-20 |