Healthcare Provider Details

I. General information

NPI: 1447732508
Provider Name (Legal Business Name): URGENT CARE TRAVEL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 02/05/2020
Certification Date: 02/05/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5931 E 32ND STREET
JOPLIN MO
64804
US

IV. Provider business mailing address

9903 SANTA MONICA BLVD STE 4500
BEVERLY HILLS CA
90212-1671
US

V. Phone/Fax

Practice location:
  • Phone: 417-952-3205
  • Fax: 417-627-5951
Mailing address:
  • Phone: 310-471-3753
  • Fax: 310-440-0997

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH MITCHELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 310-471-3753