| NPI | 1477795490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M MERCER Owner 816-500-8457 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: MO 20070007093) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2010-05-03 |