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1770152035
EBO MD OF POPLAR BLUFF LLC
POPLAR BLUFF, MO
NPI
1770152035
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Entity Type
Organization
Authorized Contact
PHILIP JAMES CROCKER
CFO
573-686-5510
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
Enumeration Date
2021-06-22
Last Update Date
2021-07-26
Business Address
EBO MD OF POPLAR BLUFF LLC
2725 N WESTWOOD BLVD
POPLAR BLUFF, MO 63901-2346
Phone number: 573-686-5510
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Mailing Address
EBO MD OF POPLAR BLUFF LLC
2725 N WESTWOOD BLVD STE 14
POPLAR BLUFF, MO 63901-2367
Phone number: 573-686-5510
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