| NPI | 1386101467 |
|---|---|
| Doing Business As | FCC PRIMARY CARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | MARY SHANE GUTHRIE Privileging Coordinator 573-888-5925 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2019-02-26 |
| Last Update Date | 2019-08-19 |