| NPI | 1376841064 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLY YVONNE GRESHAM Family Nurse Practitioner 573-727-9793 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2011-03-04 |
| Last Update Date | 2011-07-19 |