| NPI | 1013695139 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE A WILLIAMS Administrator 417-676-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment |
| Enumeration Date | 2023-07-10 |
| Last Update Date | 2023-08-23 |