| NPI | 1306629894 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON GREGORY Director 417-469-7385 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2024-03-15 |