Healthcare Provider Details

I. General information

NPI: 1457587628
Provider Name (Legal Business Name): FRANKLIN COUNTY ANIMAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2009
Last Update Date: 06/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 W 14TH ST
WASHINGTON MO
63090-4197
US

IV. Provider business mailing address

921 W 14TH ST
WASHINGTON MO
63090-4197
US

V. Phone/Fax

Practice location:
  • Phone: 636-390-9280
  • Fax: 636-390-9704
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174M00000X
TaxonomyVeterinarian
License Number6192
License Number StateMO

VIII. Authorized Official

Name: HUNT TAINTER I
Title or Position: OWNER/VETERINARIAN
Credential: DVM
Phone: 636-390-9280