| NPI | 1396821336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE SCHWALLER Administrator 573-230-3631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: MO R9C84) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2019-12-26 |