| NPI | 1164484887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM MOORE Clinic Manager 660-626-2739 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 103T00000X Psychologist |
| 204D00000X Neuromusculoskeletal Medicine & OMM | |
| 207V00000X Obstetrics & Gynecology | |
| 2084N0400X Psychiatry & Neurology Neurology | |
| 208600000X Surgery | |
| Enumeration Date | 2006-04-06 |
| Last Update Date | 2016-08-15 |