| NPI | 1487007845 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT T DEWAR Owner 417-869-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MO 11306) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |