Provider First Line Business Practice Location Address:
NORTHWEST MEDICAL CENTER
Provider Second Line Business Practice Location Address:
2210 BARRON RD, SUITE 203
Provider Business Practice Location Address City Name:
POPLAR BLUFF
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
63901
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-776-0157
Provider Business Practice Location Address Fax Number:
573-776-6504
Provider Enumeration Date:
12/16/2018