| NPI | 1386998318 |
|---|---|
| Doing Business As | BLACK RIVER MEDICAL PARTNERS |
| Entity Type | Organization |
| Authorized Contact | MICHAEL G BURCHAM President & CEO 573-727-9125 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208600000X Surgery |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-11-26 |