MISSOURI STATE UNIVERSITY NPI 1477893907

NPI Information

MISSOURI STATE UNIVERSITY is a community health clinic center in Springfield, MO. MISSOURI STATE UNIVERSITY NPI is 1477893907. The provider is registered as an organization entity type.
The provider Is Doing Business As The Kitchen Clinic.

The provider's business location address is:

1630 N JEFFERSON AVE
SPRINGFIELD, MO
ZIP 65803-819
Phone: (417) 837-1504
Fax: (417) 837-1545

The provider's authorized official is Mark Bower .
The authorized official title is Physician, Medical Director and has the following contact phone number (417) 837-1500.

The enumeration date for this NPI number is 2/20/2013 and was last updated on 2/20/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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