| NPI | 1215119508 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY RAYMOND HORNER Owner/Physician 573-638-2012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: MO 36946) |
| Additional Taxonomies | 207KI0005X Allergy & Immunology Clinical & Laboratory Immunology (Licence: MO 0340248-22) |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2015-01-22 |