Great Mines Health Center

NPI #1669654638 in De Soto, Missouri

Provider Information

NPI Number: 1669654638
Entity Type: Organization
Organization Name: Great Mines Health Center
Primary Specialty: Family Medicine
Enumeration Date: Dec 3, 2007
Last Updated: Feb 4, 2008

Practice Location

Address: 123 W PRATT ST
City: De Soto
State: Missouri
ZIP Code: 63020-2107
Phone: (636) 586-2522

Authorized Official

Name: MS. DONNA L BLOUNT
Title: OFFICE MANAGER
Phone: (573) 438-9355

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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