| NPI | 1043760184 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A TOBIN President 573-651-4488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2017-09-22 |