Healthcare Provider Details

I. General information

NPI: 1588825996
Provider Name (Legal Business Name): FAMILY PLANNING CLINIC OF FRANKLIN CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2008
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 PLAZA DR STE L
SAINT CLAIR MO
63077-1137
US

IV. Provider business mailing address

920 PLAZA DR STE L
ST CLAIR MO
63077-1137
US

V. Phone/Fax

Practice location:
  • Phone: 636-629-0300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QA0005X
TaxonomyAmbulatory Family Planning Facility
License Number
License Number State

VIII. Authorized Official

Name: GAYLE LUTZ
Title or Position: DIRECTOR REGISTERED NURSE
Credential:
Phone: 636-629-0300