| NPI | 1093339194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE ANN MEYER Fnp 573-701-1698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2020-06-04 |