| NPI | 1629283379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH KAY CROSSKNO Owner Business Manager 573-575-4416 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2020-08-22 |