| NPI | 1346308749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN W LOUDERBACK Manager 417-429-2181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO R1F83) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-10-22 |