Our Lady Queen of Peace Center, Inc.
NPI #1962459768 in Jefferson City, Missouri
Provider Information
- NPI Number
- 1962459768
- Entity Type
- Organization
- Organization Name
- Our Lady Queen of Peace Center, Inc.
- Primary Specialty
- Family Medicine
- Enumeration Date
- May 27, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 909 JEFFERSON ST
- City
- Jefferson City
- State
- Missouri
- ZIP Code
- 65101-2945
- Phone
- (573) 893-6279
Authorized Official
- Name
- CAROLYN J. TUCKER, FNP
- Title
- PRESIDENT
- Phone
- (573) 893-6279
Specialties & Taxonomy Codes
| Specialty |
|---|
| Family Medicine |
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