| NPI | 1528348430 |
|---|---|
| Doing Business As | SOUTHEAST MISSOURI RESIDENTIAL SERVICES-SIKESTON PROF GRP |
| Entity Type | Organization |
| Authorized Contact | MOLLY JANE BOECKMANN Director Of Administrative Services 573-751-4055 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207P00000X Emergency Medicine |
| Enumeration Date | 2011-08-23 |
| Last Update Date | 2020-10-20 |