| NPI | 1043363013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE R PEREZ Office Administrator 573-888-4370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: MO 117744) |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2020-08-22 |