| NPI | 1447323399 |
|---|---|
| Doing Business As | SJC-BERRYVILLE FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | VICKIE JENKINS Provider Enrollment COO Rdinator 417-829-4264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR C4889) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2008-06-27 |