| NPI | 1780982215 |
|---|---|
| Doing Business As | SOUTHEAST PRIMARY CARE - BROADWAY |
| Entity Type | Organization |
| Authorized Contact | HUBERT KING Vice Pres CFO 573-334-4822 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2011-03-08 |
| Last Update Date | 2012-12-20 |