| NPI | 1225123268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HERBERT L STANLEY Associate Director Finance 573-882-1095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2007-07-23 |