| NPI | 1184174567 |
|---|---|
| Doing Business As | BOURBON MEDICAL OFFICE |
| Entity Type | Organization |
| Authorized Contact | TONY L SCHWARM President 573-468-4186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2016-10-10 |
| Last Update Date | 2021-03-23 |