| NPI | 1780803916 |
|---|---|
| Doing Business As | PORTAGEVILLE FAMILY CLINIC |
| Entity Type | Organization |
| Authorized Contact | CHERYL A WHITE Chief Executive Officer 573-748-2404 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-04-25 |
| Last Update Date | 2011-03-07 |