NPI | 1245514959 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN E GOFF Owner 417-782-3600 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MO R7320) |
Enumeration Date | 2011-09-30 |
Last Update Date | 2011-10-06 |