Organization Name: | CONWAY FAMILY CLINIC, INC. |
NPI Number: | 1013993898 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DEE TWYMAN (PRESIDENT) |
Mailing Address: | 301 South Newport Avenue Conway |
State: | MO US |
Postal Code: | 656320009 |
Phone Number: | 4175892050 |
Fax Number: | 4175894046 |
NPI Enumeration Date: | 12/22/2005 |
NPI Last Update Date: | 12/30/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR1300X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rural Health |
Taxonomy Definition: |