| NPI | 1457402752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDWARD R DOUGLAS Owner 417-890-5585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: MO 2002013903) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2011-04-23 |