| NPI | 1124030424 |
|---|---|
| Doing Business As | PCMH CLINIC |
| Entity Type | Organization |
| Authorized Contact | JUSTIN SELLE CEO 573-754-5531 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2006-08-13 |
| Last Update Date | 2016-04-05 |