| NPI | 1467537803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID TODD QUIBELL Owner 660-747-7171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: MO 006208) |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2007-11-02 |