| NPI | 1285606392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOM LUEBBERING VP Of Finance 573-632-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2013-08-23 |