| NPI | 1528606084 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN LYNN BASHAM Managing Partner 573-410-2908 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2019-12-16 |