DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

STATE OF MISSOURI

Active Organization

ICF/Individuals with Intellectual Disabilities · POPLAR BLUFF, MO

Registration Details

NPI Number
1124198981
Provider Type
Organization
NPI Issued
Nov 9, 2006 (19.449034694018 yrs)
Last Updated
Oct 27, 2020
License
EXEMPT (MO)

Practice Information

Address
2351 KANELL BLVD
POPLAR BLUFF, MO, 639014035
Browse MO providers · Browse ZIP 63901
Phone
5738409370
Fax
5738409373
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.