| NPI | 1104147032 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ASHLOCK-RUDA Owner 417-336-3627 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 136833) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |