| NPI | 1003406539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP J CROCKER Financial Executive 573-686-5510 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2024-09-25 |