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General NPI Number Information
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NPI Number | 1003775792
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Entity Type | Organization
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Legal Business Name | UNBOUND HORIZON OUTPATIENT SERVICE
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Dates
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Enumeration Date | 01/19/2026
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Last Update Date | 01/19/2026
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Provider Practice Location Address
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Address Line | 2929 S GRAND AVE
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City | CARTHAGE
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State | MO
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Zip | 64836-7803
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Country | US
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Telephone | 417-540-4915
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Fax |
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Provider Business Mailing Address
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Address Line | 2929 S GRAND AVE
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City | CARTHAGE
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State | MO
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Zip | 64836-7803
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Country | US
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Telephone | 417-540-4915
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ASEFA GEBRE
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Credential | PHYSICIAN ASSISTANT
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Telephone | 417-540-4915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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