| NPI | 1477909372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA D LEDBETTER Director Of Operations 573-335-4715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QR1300X Clinic/Center Rural Health |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2016-05-10 |