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General NPI Number Information
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NPI Number | 1992857254
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Entity Type | Organization
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Legal Business Name | MARYVILLE R-II
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Dates
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Enumeration Date | 01/17/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1429 SOUTH MUNN AVENUE
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City | MARYVILLE
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State | MO
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Zip | 64468-2756
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Country | US
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Telephone | 660-562-3255
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Fax | 660-562-4113
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Provider Business Mailing Address
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Address Line | 1429 SOUTH MUNN AVENUE
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City | MARYVILLE
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State | MO
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Zip | 64468-2756
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Country | US
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Telephone | 660-562-3255
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Fax | 660-562-4113
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Authorized Official
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Title or Position | SUPERINTENDENT
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Name | DR. VICKIE MILLER
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Credential |
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Telephone | 660-562-3255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number |
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License Number State | MO
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