| NPI | 1063493443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHYLLIS FISCHER Business Office Manager 660-829-4024 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 261QA1903X) |
| Enumeration Date | 2005-11-11 |
| Last Update Date | 2008-07-07 |