Organization Name: | JULIA E MCNABB, D.O. LLC |
NPI Number: | 1154525053 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JULIA E MCNABB (OWNER) |
Mailing Address: | 1108 E Patterson St Suite 4 Kirksville |
State: | MO US |
Postal Code: | 635014002 |
Phone Number: | 6606275176 |
Fax Number: | 6606275180 |
NPI Enumeration Date: | 06/13/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 107000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |