| NPI | 1225261357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L STAHLY Sole Member 573-334-4110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: MO R6455) |
| Enumeration Date | 2009-08-24 |
| Last Update Date | 2009-08-24 |