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General NPI Number Information
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NPI Number | 1164239802
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Entity Type | Organization
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Legal Business Name | ON MY OWN, INC.
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Dates
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Enumeration Date | 12/16/2024
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 428 E HIGHLAND AVE
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City | NEVADA
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State | MO
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Zip | 64772-1019
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Country | US
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Telephone | 417-667-7007
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Fax | 417-667-6262
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Provider Business Mailing Address
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Address Line | 428 E HIGHLAND AVE
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City | NEVADA
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State | MO
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Zip | 64772-1019
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Country | US
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Telephone | 417-667-7007
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Fax | 417-667-6262
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. JENNIFER GUNDY
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Credential |
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Telephone | 417-667-7007
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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