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General NPI Number Information
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NPI Number | 1851649578
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Entity Type | Organization
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Legal Business Name | QUICK DRAW LABORATORY, LLC
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 400 HICKORY STREET
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City | HILLSBORO
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State | MO
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Zip | 63050-0166
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Country | US
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Telephone | 573-436-4206
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 166
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City | HILLSBORO
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State | MO
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Zip | 63050-0166
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LESLEY A WIGGER
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Credential |
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Telephone | 573-436-4206
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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