Innovative Medical Clinic
NPI #1063290260 in Jefferson City, Missouri
Provider Information
- NPI Number
- 1063290260
- Entity Type
- Organization
- Organization Name
- Innovative Medical Clinic
- Primary Specialty
- Clinic/Center - Multi-Specialty
- Enumeration Date
- Sep 19, 2023
- Last Updated
- Sep 21, 2023
Practice Location
- Address
- 3218 W EDGEWOOD DR
- Address 2
- STE 500
- City
- Jefferson City
- State
- Missouri
- ZIP Code
- 65109
- Phone
- (949) 696-6157
Authorized Official
- Name
- ELOCHUKWU OSOEGO
- Title
- OWNER
- Phone
- (949) 696-6157
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
| Clinic/Center - Urgent Care — Urgent Care |
| Clinic/Center - Multi-Specialty — Multi-Specialty |
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