Provider First Line Business Practice Location Address: 
304 E. LINCOLN WAY
    Provider Second Line Business Practice Location Address: 
NMC-NEW HAMPTON RURAL HEALTH CLINIC
    Provider Business Practice Location Address City Name: 
NEW HAMPTON
    Provider Business Practice Location Address State Name: 
MO
    Provider Business Practice Location Address Postal Code: 
64471-0222
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
660-726-3941
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
09/06/2012