| NPI | 1699007286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE B MILES Owner/Operator 417-887-1188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine Allergy & Immunology (Licence: MO R5876) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2010-02-05 |