| NPI | 1306379482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL E CRAWFORD Pmhnp 573-330-6468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| 208D00000X General Practice | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2024-12-29 |