| NPI | 1396797494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYLE G. BREEDING President 573-874-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MO R9N91) |
| Additional Taxonomies | 2086S0129X Surgery Vascular Surgery (Licence: MO R9N91) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2020-08-22 |