| NPI | 1215031737 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL BRAYFIELD Owner/Managing Employee 573-302-0670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO R1E19) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2008-06-23 |