| NPI | 1497787030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAEKAYLA WILER Administrator 573-985-7121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine |
| 208D00000X General Practice | |
| 261QP0905X Clinic/Center, Public Health, State or Local | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2023-12-28 |