Healthcare Provider Details

I. General information

NPI: 1336064815
Provider Name (Legal Business Name): ECLIPSE HEALTH CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2026
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5383 E PLEASANT VALLEY LN
SPRINGFIELD MO
65809-3175
US

IV. Provider business mailing address

5383 E PLEASANT VALLEY LN
SPRINGFIELD MO
65809-3175
US

V. Phone/Fax

Practice location:
  • Phone: 314-740-2207
  • Fax:
Mailing address:
  • Phone: 314-740-2207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN STRANCKMEYER
Title or Position: OWNER
Credential:
Phone: 314-740-2207