INNOVATIVE MEDICAL CLINIC is a multi-specialty clinic center in Jefferson City, MO. INNOVATIVE MEDICAL CLINIC NPI is 1063290260. The provider is registered as an organization entity type.
The provider's business location address is:
3218 W EDGEWOOD DR
STE 500
JEFFERSON CITY, MO
ZIP 65109
Phone: (949) 696-6157
The provider's authorized official is Elochukwu Osoego .
The authorized official title is Owner and has the following contact phone number (949) 696-6157.
The CLIA number assigned to this NPI record is 26D2237720 - practitioner other with a certificate type of Certificate of Waiver.
The enumeration date for this NPI number is 9/19/2023 and was last updated on 9/21/2023.