| NPI | 1649793076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE HAWKINS Office Manager 417-889-3332 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MO 2011010498) |
| Enumeration Date | 2017-07-18 |
| Last Update Date | 2022-07-21 |