| NPI | 1164532024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LEWIS VANDEWALKER Physician 573-634-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KA0200X Allergy & Immunology, Allergy (Licence: MO R2F17) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-10-03 |