| NPI | 1043622368 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRANT B OLSON President/Owner 417-889-4746 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MO 2011016216) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2014-05-21 |