NPI 1508936519

Boys&girlstownofmo

Organisation Exclusive Provider Organization Springfield, MO

Practice location

Address: 1212 W Lombard St, Springfield, MO 65806-2720
Phone: (417) 865-1646
Mailing address: 3535 S Valley View Ave, Springfield, MO 65804-4686

Authorised official

Name: Joan J Schutz
Title: Therapist
Phone: (417) 865-1646

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 1999137154 (MO)

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Registry record

NPI: 1508936519
Entity type: Organization
NPI issued: 8 Nov 2006
Record last updated: 22 Aug 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.