| NPI | 1629105770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE ANN GIPSON Administrator 417-447-2482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: MO 148-1) |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2013-03-14 |