| NPI | 1225016884 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT D SMITH Owner 573-686-2811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: MO R5B27) |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2008-04-29 |