| NPI | 1609960509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDALL A. PERRY President 573-876-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 107883) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MO 107883) |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2012-09-05 |