| NPI | 1235126921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE DOEBELIN Executive Director 573-884-1753 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2023-11-10 |