| NPI | 1225682529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN HAMLIN Owner 417-717-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-07-25 |
| Last Update Date | 2021-07-08 |