OrganizationActive
Bonne Terre Health Clinic LLC
NPI 1104071935 · Rural Health Clinic/Center · Bonne Terre, MO
Provider details
- NPI number
- 1104071935
- Entity type
- Organization
- Primary specialty
- Rural Health Clinic/CenterAmbulatory Health Care Facilities
- Authorized official
- Andrew Ninichuck, Member
- License
- 102387 (MO)
Practice location
55 Nesbit Dr
Bonne Terre, MO 63628-1353
Phone: (573) 358-3343
Fax: (573) 358-5458
Mailing address
55 Nesbit Dr
Bonne Terre, MO 63628-1353
Registry dates
- Enumerated
- 2008-11-20
- Last updated
- 2009-09-24
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.