| NPI | 1013963453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE M REINEKE Administrator 417-781-2807 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: MO 106-6) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2020-08-22 |