| Organization Name: | I AM HEALTH CLINIC, LLC |
| NPI Number: | 1104106103 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CHERI K ALLISON (OWNER/MANAGER) |
| Mailing Address: | 1005 S Allison Rd Suite A El Dorado Springs |
| State: | MO US |
| Postal Code: | 647442431 |
| Phone Number: | 4178764771 |
| Fax Number: | 4178764775 |
| NPI Enumeration Date: | 08/22/2011 |
| NPI Last Update Date: | 08/22/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Primary Care |
| Taxonomy Definition: | |