| NPI | 1104010081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALFREDA P. SPENCER Director 573-996-2224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: MO 266063619) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-10-09 |