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General NPI Number Information
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NPI Number | 1154525053
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Entity Type | Organization
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Legal Business Name | JULIA E MCNABB, D.O. LLC
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Dates
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Enumeration Date | 06/13/2007
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Last Update Date | 10/25/2021
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Provider Practice Location Address
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Address Line | 513 N OLIVE ST
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City | QUEEN CITY
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State | MO
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Zip | 63561-1054
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Country | US
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Telephone | 660-766-2300
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Fax | 626-593-4791
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Provider Business Mailing Address
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Address Line | PO BOX 40
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City | QUEEN CITY
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State | MO
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Zip | 63561-0040
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Country | US
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Telephone | 660-766-2300
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Fax | 626-593-4791
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Authorized Official
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Title or Position | OWNER
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Name | DR. JULIA E MCNABB
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Credential | D.O.
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Telephone | 660-626-5413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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