| NPI | 1144283524 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLINT VANLANDINGHAM Owner 573-785-4546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MO 2004001321) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-04-07 |
| Last Update Date | 2020-05-15 |