NPI | 1053853226 |
---|---|
Entity Type | Organization |
Authorized Contact | MARLEY PAGE Director 417-861-9739 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
Additional Taxonomies | 208000000X Pediatrics |
261QU0200X Clinic/Center, Urgent Care | |
Enumeration Date | 2016-11-04 |
Last Update Date | 2025-06-25 |