Healthcare Provider Details

I. General information

NPI: 1295801926
Provider Name (Legal Business Name): KESSINGER DIAGNOSTIC CENTRE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 US HWY 72 E
ROLLA MO
65401
US

IV. Provider business mailing address

411 US HWY 72 E
ROLLA MO
65401
US

V. Phone/Fax

Practice location:
  • Phone: 573-341-8292
  • Fax: 573-341-8494
Mailing address:
  • Phone: 573-341-8292
  • Fax: 573-341-8494

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code111NI0900X
TaxonomyInternist Chiropractor
License Number
License Number StateMO

VIII. Authorized Official

Name: MRS. VIRGINIA KESSINGER
Title or Position: OFFICE MANAGER
Credential:
Phone: 573-341-8292