| NPI | 1225101157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE LILLIAN STINE Administrator 573-471-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 37010) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MO 37010) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2020-08-22 |