| NPI | 1245345958 |
|---|---|
| Other Name | MAIN STREET MEDICAL CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHARLES R. KLEPPER Owner 870-741-3592 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2014-04-30 |