| NPI | 1326099417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLUYOMI OLUSANYA Owner/Del Official 573-426-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2002009086) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 124268) | |
| Enumeration Date | 2006-05-13 |
| Last Update Date | 2017-09-14 |