| NPI | 1497014542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW ALEX BEDELL Member 660-429-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: MO 2002024548) |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |