Preventive Healthcare
NPI #1194019521 in Saint James, Missouri
Provider Information
- NPI Number
- 1194019521
- Entity Type
- Organization
- Organization Name
- Preventive Healthcare
- Primary Specialty
- Clinic/Center - Primary Care
- Enumeration Date
- Jun 2, 2011
- Last Updated
- Sep 1, 2011
Practice Location
- Address
- 201 N JEFFERSON ST
- Address 2
- SUITE D
- City
- Saint James
- State
- Missouri
- ZIP Code
- 65559-1919
- Phone
- (573) 265-0911
Authorized Official
- Name
- DR. BRENT K CAUDILL, M.D.
- Title
- OWNER/DOCTOR
- Phone
- (573) 265-0911
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Primary Care — Primary Care |
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