| NPI | 1598727463 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZIE VICKERY Surgery Administrator 573-335-9175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 53-12) |
| Enumeration Date | 2006-04-05 |
| Last Update Date | 2008-04-20 |