| Organization Name: | PROFESSIONAL CLINICS, LLC |
| NPI Number: | 1477909372 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | AMELIA D LEDBETTER (DIRECTOR OF OPERATIONS) |
| Mailing Address: | 624 Old Saint Marys Rd Suite A Perryville |
| State: | MO US |
| Postal Code: | 637751837 |
| Phone Number: | 5735473232 |
| Fax Number: | 5735473231 |
| NPI Enumeration Date: | 05/10/2016 |
| NPI Last Update Date: | 05/10/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |